Timing and technic of the surgical correction of childhood intersex genitals including the procedure for partial vaginal aplasia

Abstract

The author holds the opinion that surgical correction of intersexual outer genital should be performed before the second birthday. In case of an adrenogenital syndrome with deep (peripheral) junction of the vagina into the urogenital sinus, vaginoplasty of the introitus and displacement of the clitoris should be performed in a single session. The author describes his own operational technique. If the vagina enters the urogenital sinus near the bladder, the author recommends to employ the operation technique described by Hendrin for removal and reimplantation of the vagina into the perineum, combined with the author's own technique of displacing the clitoris. Partial absence or atrophy of the vagina was seen in 8 cases. The author describes his own abdominoperineal operation method for correcting this defect. In cases where the intersexual genital is to be corrected in the direction of a male genital, the author recommends shaft erection in the first session and urethroplasty in the second session according to the technique described by Denis Browne. In all, 132 patients were surgically treated for correction of an intersexual genital.