Лечение вестибуло-вагинальной гипоспадии.

Abstract

Introduction. Vestibulovaginal hypospadias is a rare pathology, which is an embryonic malformation of both the urinary and reproductive systems. Various surgical methods are used to treat this malformation, the results of which are not always positive. Purpose. To develop a surgical correction option for vestibulovaginal hypospadias. Materials and methods. 16 girls with svestibular-vaginal hypospadias were observed. 8 girls underwent surgery – isolation of the urethra from the external opening to the neck of the bladder and moving it below the clitoris. Results. The vulvo-vaginal form was manifested by dystopia of the external urethral opening. All had vulvitis, vaginitis, chronic cystitis and pyelonephritis. X-ray examination revealed Vesicoureteral reflux (VUR) in 6 children, and ureterohydronephrosis in 2 children. All girls were treated conservatively with temporary success. Surgical treatment was performed in 8 girls with good long-term results. Conclusion. The ineffectiveness of long-term therapy for vulvitis, vaginitis, cystitis, and chronic pyelonephritis is an indication for surgical treatment of vestibulovaginal hypospadias. Permanent trauma to the external opening of the urethra during coitus is a predisposing factor for urinary tract infection in mature women. Correction of an abnormal urethra in childhood serves as a prevention of postcoital complications in the future.