Partial Urogenital Mobilization. Our Initial Experience

• Published in: Journal of pediatric urology Vol. 4; p. S80
• Main Author: George TSACHOURIDIS, Antonios STEPHANIDIS
• Format: Journal Article
• Language: English
• Published: Elsevier Ltd 2008
• Subjects: Pediatrics; Urology
• ISSN: 1477-5131; 1873-4898
• DOI: 10.1016/j.jpurol.2008.01.119

Abstract PURPOSE The treatment of urogenital sinus (UGS) malformations despite various surgical techniques remains complex and controversial. We present our functional and cosmetic results in 5 cases which underwent partial urogenital mobilization (PUM). MATERIAL AND METHODS From January 2004 to April 2007 five patients with (UGS) anomalies, included one with congenital adrenal hyperplasia (CAH), underwent PUM with reduction clitoroplasty in the case of CAH. Their age at surgery was 1 month, 3 months, 1, 5.5 and 12 years respectively. PUM is based on the total urogenital mobilization (TUM) technique but the dissection of the common channel is limited to being distal to the pubourethral ligament. RESULTS Follow up ranged from 7 months to 3.5 years. The 2 older children remained continent with physiological urinary stream and normal uroflow studies. The vagina had a physiological position in all patients and none of them developed vaginal stenosis during our relatively short follow up period. In the case of CAH the cosmetic appearance was nearly physiological with normal appeared clitoris, orthotopic urethral meatus, minor and major labias. CONCLUSIONS PUM is a less invasive method leaving the continence mechanism and clitoral sensation intact. It limits potential morbidity and gives a cosmetically satisfactory result. More cases and long term follow up is needed to prove the final functional and cosmetic outcome.