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Adamyan L.V.

Moscow State Medical and Dental University named after A.I. Evdokimov

Nikolaev V.V.

Russian Children’s Clinical Hospital

Bizhanova D.A.

Russian Children’s Clinical Hospital

Sibirskaya E.V.

Moscow State University of Medicine and Dentistry named after A.I. Evdokimov;
Morozovskaya Children’s City Clinical Hospital of the Moscow Department of Health;
Pirogov Russian National Research Medical University

Karachentsova I.V.

Pirogov Russian National Research Medical University;
Russian Children’s Clinical Hospital

Argun M.Z.

Russian Children’s Clinical Hospital;
Pirogov Russian National Research Medical University, Mosco

Turchinets A.I.

Pirogov Russian National Research Medical University

Feminizig genitoplasty in congenital adrenal hyperplasia: an overview

Authors:

Adamyan L.V., Nikolaev V.V., Bizhanova D.A., Sibirskaya E.V., Karachentsova I.V., Argun M.Z., Turchinets A.I.

More about the authors

Journal: Russian Journal of Human Reproduction. 2021;27(6): 56‑65

DOI: 10.17116/repro20212706156

Read: 6579 times

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Table of contents

FEMINIZIG GENITOPLASTY IN CONGENITAL ADRENAL HYPERPLASIA: AN OVERVIEW
FEMINIZIG GENITOPLASTY IN CONGENITAL ADRENAL HYPERPLASIA: AN OVERVIEW

To cite this article:

Adamyan LV, Nikolaev VV, Bizhanova DA, Sibirskaya EV, Karachentsova IV, Argun MZ, Turchinets AI. Feminizig genitoplasty in congenital adrenal hyperplasia: an overview. Russian Journal of Human Reproduction. 2021;27(6):56‑65. (In Russ.)
https://doi.org/10.17116/repro20212706156

Подписка 2026 Проблемы репродукции (Russian Journal of Human Reproduction)
МСФ на ЯМ
Использование инфографики авторами научных работ
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Abstract:

INTRODUCTION

Feminizing genitoplasty is performed for girls with CAH with the aim of the patient’s sexual self-identification, which occurs by the age of 2—2.5 years, the child’s social and psychological adaptation in the collective, as well as in order for patients to be able to have sexual intercourse in future. Surgical treatment is performed on patients with severe virilization of the external genitals (Prader III—V). The surgical techniques for feminization of the external genitals include clitoroplasty, UGS mobilization and the creation of a functional entrance to the vagina.

TIME AND STAGE OF PERFORMANCE OF THE SURGERY

The latest literature provides us with conflicting discussions about the timing and options for performing one-stage or two-stage feminizing genitoplasty. There are currently no randomized controlled trials regarding the timing of surgery, and most publications are based on expert opinions obtained from research by one or more centers. The advantages of an early one-stage surgery are the possibility of using excess tissue of the UGS for the reconstruction of the anterior vaginal wall. Two-stage feminizing genitoplasty is determined by estrogenization of the external genital organs in puberty, as well as by reducing the time between vaginoplasty and the patient’s onset of sexual activity, preventing possible postoperative stenosis.

CLITOROPLASTY

The approach to the surgical treatment of clitoromegaly has historically undergone significant changes due to the enrichment of knowledge about the functions of the clitoris, the emergence of new publications on the innervation of the clitoris head, as well as attempts to minimize the irreversible results of surgical treatment on the possible development of gender dysphoria in patients. The methods of surgical correction of clitoromegaly in modern surgery follow the basic rule — preservation of the dorsal vascular bundle to maintain sufficient vascularization and sensitivity of the head to preserve the function of the clitoris

VAGINOPLASTY

There are 4 main types of vaginoplasty: «cut-back» midline sinus dissection, neovagina formation, posterior skin plap vaginoplasty, and «pull-through» vaginoplasty.

CONCLUSION

All modern methods of clitoroplasty and vaginoplasty are aimed at the possibility of maintaining psychosexual well-being. There are still no reliable studies on the benefits of performing feminizing plastic surgery in one or two stages, which requires further study and optimization of the tactics of surgical treatment of patients.

Keywords:

feminizing genitoplasty
vaginoplasty
clitoroplasty
congenital adrenal hyperplasia
urogenital sinus

Authors:

Adamyan L.V.

Moscow State Medical and Dental University named after A.I. Evdokimov

Nikolaev V.V.

Russian Children’s Clinical Hospital

Bizhanova D.A.

Russian Children’s Clinical Hospital

Sibirskaya E.V.

Moscow State University of Medicine and Dentistry named after A.I. Evdokimov;
Morozovskaya Children’s City Clinical Hospital of the Moscow Department of Health;
Pirogov Russian National Research Medical University

Karachentsova I.V.

Pirogov Russian National Research Medical University;
Russian Children’s Clinical Hospital

Argun M.Z.

Russian Children’s Clinical Hospital;
Pirogov Russian National Research Medical University, Mosco

Turchinets A.I.

Pirogov Russian National Research Medical University

Received:

19.08.2021

Accepted:

25.10.2021

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