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Reconstructieve chirurgische behandeling bij meisjes met disorders of sex development

Nijmeegse ervaringen in de afgelopen decennia

  • Published:
Tijdschrift voor Kindergeneeskunde

Samenvatting

Sinds 1973 zijn er in het UMC St Radboud correcties van de uitwendige genitalia uitgevoerd bij meisjes met een disorder of sex development (DSD) meestal op basis van een adrenogenitaal syndroom (AGS). Deze correctie gebeurde door middel van een eenmalige complete reconstructieve procedure. Operatieve techniek en timing werden in de loop van de jaren aangepast. De huidige operatieve behandeling betreft een eenmalige reconstructie binnen 4 tot 6 weken na de geboorte door middel van een ‘pull-through vaginoplastiek’, een omegaflap verwijdingsplastiek en een anterieure corpora cavernosa ‘clitorisreductieplastiek’ met de bedoeling het uitwendig aspect te verbeteren, reoperaties te vermijden en de seksuele ontwikkeling zo min mogelijk te verstoren.

Summary

Since 1973 we have performed feminizing genitoplasty surgery in females with congenital adrenal hyperplasia (CAH) by a single stage procedure in early infancy. Operative strategy, timing and technique were reconsidered several times and changed accordingly. Current surgical treatment consists of a reconstruction within 4 to 6 weeks after birth, by a ‘pull-through vaginoplasty’ with omega-flap inlay and an anterior corpora cavernosa reduction ‘clitoroplasty’ in order to improve external aspect, to avoid secondary surgery in the future and to improve normal sexual development.

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Authors and Affiliations

  1. www.bsl.nl/shop/tydschrift-vkindergeneeskunde-0376-7442.html

    P. N. M. A. Rieu

Authors
  1. P. N. M. A. Rieu
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  2. W. F. J. Feitz
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  3. W. N. P. Willemsen
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  4. E. M. van Kuyk
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  5. M. M. L. Stikkelbroeck
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  6. B. J. Otten
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Corresponding author

Correspondence to P. N. M. A. Rieu.

Additional information

Dhr. dr. P.N.M.A. Rieu, kinderchirurg, afdeling Heelkunde aandachtsgebied kinderchirurgie, dhr. prof. dr. W.F.J. Feitz, kinderuroloog, afdeling Urologie aandachtsgebied kinderurologie, dhr. dr. W.N.P. Willemsen, gynaecoloog, afdeling Obstetrie/Gynaecologie, mw. drs. E.M. van Kuyk, gezondheidszorg psycholoog, afdeling Medische Psychologie, mw. dr. M.M.L. Stikkelbroeck, internist in opleiding, afdeling Interne Geneeskunde, dhr. dr. B.J. Otten, kinderarts/endocrinoloog, subafdeling Kinderendocrinologie, UMC St Radboud, Nijmegen.

Correspondentieadres: Dr. P.N.M.A. Rieu, afdeling Kinderchirurgie, UMC St Radboud, Postbus 9101, 6500 HB Nijmegen, tel: 024-3619761,

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Rieu, P.N.M.A., Feitz, W.F.J., Willemsen, W.N.P. et al. Reconstructieve chirurgische behandeling bij meisjes met disorders of sex development. KIND 76, 117–120 (2008). https://doi.org/10.1007/BF03078190

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  • DOI: https://doi.org/10.1007/BF03078190

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