International Urology and Nephrology

, Volume 40, Issue 3, pp 557–559 | Cite as

An insight into vaginal surgery in a severely masculinized CAH patient

  • Peter NyiradyEmail author
  • Adrian Bianchi
  • David C. S. Gough
Urology - Case Report


Reconstruction and exteriorization of the “high” vagina in girls with congenital adrenal hyperplasia (CAH) is technically challenging. Although current surgical thinking favors correction in infancy the evidence from several long-term studies indicates that many patients will require further surgery in adolescence or adult life. Deferred vaginoplasty has been advocated because the procedure may be technically easier as a consequence of changes in the characteristics of the genital tissues and vaginal anatomy. The role of urogenital mobilization is as yet undetermined but carries promise for the short, high vagina. We describe a patient where the radiological and clinical findings support the argument for deferred vaginoplasty.


Congenital adrenal hyperplasia Ambiguous genitalia Vaginoplasty Urogenital sinus mobilization 


  1. 1.
    Thomas DFM (2004) Gender assignment: background and current controversies. BJU Int 93(Suppl 3):47–50PubMedCrossRefGoogle Scholar
  2. 2.
    Passerini-Glazel G (1989) A new 1-stage procedure for clitorovaginoplasty in severely masculinized female pseudohermaphrodites. J Urol 142:565PubMedGoogle Scholar
  3. 3.
    Tillem SM, Stock JA, Hanna MK (1998) Vaginal construction in children. J Urol 160:186PubMedCrossRefGoogle Scholar
  4. 4.
    Pena A, Filmer B, Bonilla E, Mendez M, Stolar C (1992) Transanorectal approach for the treatment of urogenital sinus: preliminary report. J Pediatr Surg 27:681PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, B.V. 2008

Authors and Affiliations

  • Peter Nyirady
    • 1
    • 2
    Email author
  • Adrian Bianchi
    • 1
  • David C. S. Gough
    • 1
  1. 1.Department of Paediatric UrologyRoyal Manchester Children’s HospitalManchesterUK
  2. 2.Department of UrologySemmelweis UniversityBudapestHungary

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