Surgical correction of external genitalia and lower genitourinary tract of markedly virilized child.

Three children who were seen with marked androgenization, including clitoromegaly, labial fusion, and absent vaginal introitus are presented. In each, the vagina was found to be entering at the level of the posterior urethra. Vaginoplasty was performed in each child utilizing a transperineal "pull through" technique. Reduction clitoroplasty was performed in 1 patient. The advantages and optimal timing of these techniques are discussed.