Outcomes and Risk Factors in Urogenital Mobilization

Abstract

PURPOSE Urogenital mobilization is a recent advance in reconstruction for urogenital sinus anomalies. Use of the mobilized sinus has improved cosmetics and function. Concern remains regarding outcomes, particularly continence with total or urogenital mobilization techniques. Other concerns include delayed stress incontinence, sensation loss and vaginal foreshortening. MATERIAL AND METHODS We reviewed our last 50 vaginoplasties; 44 of whom had either a total or partial urogenital mobilization. This group of 44 was analyzed for early continence, cosmetics and vaginal stenosis, as well as underlyling neurologic status. RESULTS Eighteen underwent TUM (7 neurologically normal, 11 have significant neurologic or anatomic abnormalities): 26 underwent PUM (25 neurologically normal, only 1 had a neurologic abnormality). Neurologically normal children > 3 years old are continent regardless of TUM versus PUM. Of those neurologically impaired, 2 are dry voiding, 7 are dry with CIC and 2 are wet. Only 1 of 44 has vaginal stenosis. Cosmetics are excellent. CONCLUSIONS PUM and TUM appear safe from an early continence standpoint. Early continence appears to be related more to underlying neurological status than the procedure. Cosmetics are excellent. Vaginal stenosis has been rare. Late stress continence, sensation, or need for secondary procedures following TUM or PUM remain unknown.