Pediatric Surgery and Urology Department, Motol University Hospital, Charles University, Prague, The Czech Republic.
Great Ormond Street Hospital for Children, London, United Kingdom.
J Urol. 2021 May;205(5):1483-1489. doi: 10.1097/JU.0000000000001509. Epub 2020 Dec 21.
We investigated quality of life, long-term lower urinary tract symptoms, sexual function and subjective attitudes toward surgery in adult women after feminizing genitoplasty for congenital adrenal hyperplasia.
We retrospectively reviewed the medical files of all patients with congenital adrenal hyperplasia who underwent feminizing genitoplasty from 1996 to 2018 in our tertiary center. Of those, patients older than 16 years of age were asked to answer 1 nonvalidated and 3 standardized and validated questionnaires evaluating their current mental well-being (WHO-5 Well-Being Index), lower urinary tract symptoms (ICIQ-FLUTS) and sexual function (GRISS). The anonymized answers of this cross-sectional study were compared to a control group of 50 healthy females. Student's t-test, Pearson's χ test, Fisher's exact test and Spearman's rank correlation coefficient were performed. A p-value less than 0.05 was considered significant.
Out of 106 patients who underwent feminizing genitoplasty, 64 patients were included and 32 patients, aged 17 to 40 years (median 25.5 years), answered the questionnaires (50% response rate). The difference between congenital adrenal hyperplasia and control group mental well-being was not statistically significant (WHO-5 median score 60 and 64, respectively; p=0.82). We found no significant difference in the lower urinary tract symptoms subscales of filling, voiding or incontinence, nor in the overall lower urinary tract symptoms score (ICIQ-FLUTS overall median score 3.5 and 3, respectively; p=0.43).
We found in our group no abnormal mental well-being or prevalence of long-term symptoms of lower urinary tract dysfunction in adult female patients with congenital adrenal hyperplasia following feminizing genitoplasty.
我们研究了女性先天性肾上腺皮质增生症患者接受女性化生殖器成形术后的生活质量、长期下尿路症状、性功能以及对手术的主观态度。
我们回顾性分析了 1996 年至 2018 年在我们的三级中心接受女性化生殖器成形术的所有先天性肾上腺皮质增生症患者的病历。其中，年龄大于 16 岁的患者被要求回答 1 个非验证和 3 个标准化和验证的问卷，评估他们目前的心理健康（WHO-5 幸福感指数）、下尿路症状（ICIQ-FLUTS）和性功能（GRISS）。这项横断面研究的匿名答案与 50 名健康女性的对照组进行了比较。采用 Student's t 检验、Pearson χ 检验、Fisher 确切检验和 Spearman 秩相关系数进行分析。p 值小于 0.05 被认为具有统计学意义。
在 106 例接受女性化生殖器成形术的患者中，纳入了 64 例患者，其中 32 例年龄在 17 至 40 岁之间（中位数 25.5 岁）回答了问卷（50%的应答率）。先天性肾上腺皮质增生症组和对照组的心理健康评分差异无统计学意义（WHO-5 中位数评分分别为 60 和 64；p=0.82）。我们发现下尿路症状的充盈、排空或失禁亚量表以及下尿路症状总体评分均无显著差异（ICIQ-FLUTS 总体中位数评分分别为 3.5 和 3；p=0.43）。
我们发现，在我们的研究组中，接受女性化生殖器成形术的女性先天性肾上腺皮质增生症患者没有异常的心理健康或长期下尿路功能障碍症状。
