Abstract
Abstract Purpose To evaluate the sensitivity of external genitalia and to assess sexual function and orgasm in a group of adult patients submitted to early feminizing genitoplasty during childhood. Material and Methods We included patients affected by congenital adrenal hyperplasia, who were surgically treated in their infancy, now aged 18 years or more and requiring a complete sexual life. Thermal and vibratory sensibility of clitoris, vagina and labia minora were analyzed using the Genito-Sensory Analayzer (GSA), a device aimed at determining temperature and vibratory measurements, with a feedback patient-response switch. Psychosexual outcome was assessed with validated questionnaires. Results Fifteen patients entered the stdy. At GSA evaluation thermal sensibility appeared decreased both at the clitoris and vagina, whereas vibratory sensibility was decreased at the clitoris but within normal limits at the vagina in all cases. Questionnaires showed slight depression in 3 patients; slight anxiety in all patients; active sexual desire, good arousal, adequate lubrification and presence of orgasm in all patients. Eight patients described stable satisfactory heterosexual relationship, 3 patients reported stable unsatisfactory heterosexual relationship without penetration, 3 patients refused the test, and 1 patient described a satisfactory homosexual relationship. Conclusions Our study suggests that vaginal vibratory sensibility was conserved in all patients, whereas clitoral vibratory sensibility, vaginal thermal sensibility and clitoral thermal sensibility were altered. It was not possible to verify if these results have to be attributed to the surgical technique, to the age at surgery, or to the original malformation of the external genitalia. All patients reported orgasm even in absence of penetration.
Published Version
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