Correction of Clitoral Hypertrophy and Urogenital Sinus with Low Vaginal Entry
When the external genitalia are to be reconstructed along female lines, the first step is to determine the level at which the vagina enters the urogenital sinus. Usually this can be assessed by means of genitography (Fig. 7d), but if this is not sufficient endoscopy (uteroscopy) will be required. It must be determined whether the correction can be effected by a simple vaginoplasty or whether the vagina will have to be detached from the urogenital sinus and pulled through to the perineum. The surgical approach differs for each procedure. If preoperative studies indicate a low vaginal entry, but a vaginal orifice is not found at operation, the operation should be terminated, the urogenital sinus closed, and the previously mobilized skin flap sutured back into place. A vaginal pullthrough operation can then be performed about 6 months later (see p. 50).
KeywordsSkin Flap Pubic Symphysis Urogenital Sinus Stay Suture Sinus Opening
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