Miranda Márcio Lopes, Oliveira-Filho Antônio Gonçalves de, Lemos-Marini Sofia Helena V, Guerra Gil, Bustorff-Silva Joaquim Murray
Division of Pediatric Surgery and Pediatric Endocrinology, State University of Campinas (UNICAMP), Campinas, Sao Paulo, Brazil.
J Pediatr Surg. 2004 Jul;39(7):1030-3. doi: 10.1016/j.jpedsurg.2004.03.060.
BACKGROUND/PURPOSE: Stenosis of the vaginal introitus is the most frequent complication after genital reconstruction for ambiguous genitalia associated with congenital adrenal hyperplasia (CAH). With the aim of enlarging the vaginal introitus, the authors present a technical modification of the introitoplasty that uses a bilateral cutaneous island flap based on the perineal superficial branches of the internal pudendal artery.
Eleven girls with CAH and Prader III to V genital ambiguity were included. Feminizing genitoplasty was performed in 1 stage. Bilateral cutaneous labioescrotal island flaps, based on the posterior labial artery, were included in the introitoplasty. The cosmetic results of the genitoplasty were evaluated by photographic analysis of the external genitalia.
Integrity of the vaginal introitus as well as excellent integration of the flap and absence of additional scars in the donor area were assessed in all girls.
This modified island flap is technically feasible and reproducible producing no additional sequels in the donor area. It uses perineal skin that is usually excised in other techniques avoiding the use of harvesting skin from adjacent areas. Thus, it can be a useful additional procedure in the introitoplasty in association with the currently used techniques.
背景/目的：阴道入口狭窄是先天性肾上腺皮质增生症（CAH）相关的两性畸形生殖器重建术后最常见的并发症。为了扩大阴道入口，作者介绍了一种改良的阴道成形术技术，该技术使用基于阴部内动脉会阴浅支的双侧皮岛瓣。
纳入11例患有CAH且Prader III至V级生殖器模糊的女孩。一期进行女性化生殖器成形术。阴道成形术中纳入基于阴唇后动脉的双侧阴唇阴囊皮岛瓣。通过对外生殖器的照片分析评估生殖器成形术的美容效果。
评估了所有女孩的阴道入口完整性以及皮瓣的良好整合情况和供区无额外瘢痕。
这种改良的岛状皮瓣在技术上是可行且可重复的，在供区不会产生额外的后遗症。它使用通常在其他技术中切除的会阴皮肤，避免从相邻区域取皮。因此，它可以作为与目前使用的技术相结合的阴道成形术中一种有用的附加手术。
