558 VAGINOPLASTY OUTCOMES: CONFLUENCE LEVEL AND TIMING OF PROCEDURE

Abstract

You have accessJournal of UrologyPediatrics: Congenital Anomalies - Lower Urinary Tract & Genitalia1 Apr 2011558 VAGINOPLASTY OUTCOMES: CONFLUENCE LEVEL AND TIMING OF PROCEDURE Blake Palmer, Brandon Trojan, Katie Griffin, William Reiner, Amy Wisniewski, Dominic Frimberger, and Bradley Kropp Blake PalmerBlake Palmer Oklahoma City, OK More articles by this author , Brandon TrojanBrandon Trojan Oklahoma City, OK More articles by this author , Katie GriffinKatie Griffin Oklahoma City, OK More articles by this author , William ReinerWilliam Reiner Oklahoma City, OK More articles by this author , Amy WisniewskiAmy Wisniewski Oklahoma City, OK More articles by this author , Dominic FrimbergerDominic Frimberger Oklahoma City, OK More articles by this author , and Bradley KroppBradley Kropp Oklahoma City, OK More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.1283AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Questions regarding the best procedure, timing, and surgical outcomes for patients requiring vaginoplasty remain. Much of the data refer to outdated management and are unhelpful in drawing conclusions about present day management. One of the few outcome studies regarding use of the total urogenital mobilization for congenital adrenal hyperplasia (CAH) and cloacal anomalies (C) and the effects on their bladder only reviewed patients with a low confluence or short common channel. Others, with small sample sizes have shown continence can be achieved in young patients undergoing urogenital mobilization. To our knowledge there is limited data regarding the differences between operative blood loss, operative time, hospital stay, incidence of urinary tract infections and continence stratified according by anatomy type and timing of procedure. METHODS We retrospectively reviewed consecutive vaginoplasties performed at our institution from 1997–2010 for patients with CAH, urogenital sinus (UGS), and C. Pre operative, operative and follow up data were collected. Data were analyzed using two-tailed t-tests. RESULTS A total of 25 patients underwent vaginoplasty reconstruction for CAH, UGS, and C. Those with a high confluence (n=13) had a common channel length on average of 3.38 cm (SEM 0.15) compared to an average of 1.65 cm (0.21) for those with a low confluence (n=12). The operative time was 7.17 hours (0.49) vs 3.6 (0.34) for high vs low, respectively (p<0.05). The percentage of estimated total blood volume lost during the procedure was 11.9% (0.03) for high on average and 4.3% (0.01) on average for low (p<0.05). The hospital stay was on average 2.77 days (0.32) for high vs 1.73 (0.30) for low (p<0.05). When comparing those operated on after adolescents (n=7) vs those prior to adolescents (n=18) there were no differences for any dependent measures of interest. Continence was achieved by the age of 3 years in all patients regardless of the level of confluence or age at surgery. CONCLUSIONS As expected, patients with CAH, UGS, and C with a high confluence have a more difficult surgery than those with a low confluence. However, a high confluence did not impart worse outcomes for ultimate urinary continence. The age at surgery did not show any effects on the surgery or urinary outcomes. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e225-e226 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Blake Palmer Oklahoma City, OK More articles by this author Brandon Trojan Oklahoma City, OK More articles by this author Katie Griffin Oklahoma City, OK More articles by this author William Reiner Oklahoma City, OK More articles by this author Amy Wisniewski Oklahoma City, OK More articles by this author Dominic Frimberger Oklahoma City, OK More articles by this author Bradley Kropp Oklahoma City, OK More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...