Surgical Outcomes of Clitoroplasty in Children with Congenital Adrenal Hyperplasia and Clitoral Hypertrophy: A 19-Year Experience of a Single Surgeon

Jaebeom Jun, Sang Hoon Song, Sungchan Park, Jae Hyeon Han and Kun Suk Kim
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Jaebeom Jun: Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05535, Korea
Sang Hoon Song: Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05535, Korea
Sungchan Park: Department of Urology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan 44033, Korea
Jae Hyeon Han: Department of Urology, Korea University Ansan Hospital, Korea University College of Medicine, Ansan 15355, Korea
Kun Suk Kim: Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05535, Korea

IJERPH, 2021, vol. 18, issue 21, 1-9

Abstract: This study aimed to describe the experience with clitoroplasty for clitoral hypertrophy in patients with congenital adrenal hyperplasia of a single surgeon. The medical records of female pediatric patients with congenital adrenal hyperplasia who underwent clitoroplasty at a tertiary referral hospital between 2002 and 2020 were retrospectively analyzed. Three different surgical techniques were applied for clitoroplasty: recession without reduction, reduction and recession, and girth reduction and recession. A total of 104 patients underwent clitoroplasty for clitoral hypertrophy. The median patient age at the time of surgery was 10 months (range, 4 months to 10 years). The operation time was longer in reduction clitoroplasty than in recession clitoroplasty without reduction (median, 153 vs. 111 min, p = 0.003). The mean postoperative pain score of the patients did not differ among the different clitoroplasty techniques. During the mean follow-up of 37.7 months, nine (8.6%) patients underwent reperformed clitoroplasty. The rate of reperformed operation was significantly higher in patients who underwent reduction clitoroplasty (17.3%) than in those who underwent recession without reduction (2%) or girth reduction and recession (0%) ( p = 0.031). Early clitoroplasty in patients with congenital adrenal hyperplasia yielded good mid-term surgical outcomes in terms of cosmesis and recurrence rate, with minimal perioperative complications.

Keywords: congenital adrenal hyperplasia; disorders of sex development; feminizing surgery; 21-hydroxylase deficiency (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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