Comparison of Functional and Cosmetric Effects and Postoperative Complications: Passerine and TUM Vaginoplasty for Two CAH & Cloacal Malformations

Mollaeian, M; Sadid, D; Eskandari Torbaghan, F; Ahmadi, A; Tolou Ostadan Yazd, MR

Comparison of Functional and Cosmetric Effects and Postoperative Complications: Passerine and TUM Vaginoplasty for Two CAH & Cloacal Malformations

Document Type : Original Article

Authors

M Mollaeian ¹

D Sadid ²

F Eskandari Torbaghan ³

A Ahmadi ⁴

MR Tolou Ostadan Yazd ³

¹ Associate Professor, Department of Pediatric Surgery, Tehran University of Medical Sciences, Bahrami Hospital

² Resident of Pediatric Surgery, Tehran University of Medical Sciences and Health Services, Bahrami Hospital, Tehran, Iran

³ Assistant Professor, Department of Pediatric Surgery, Tehran University of Medical Sciences, Bahrami Hospital

⁴ Assistant Professor, Department of Statistics and Research, Tehran University of Medical Sciences

Abstract

Introduction & Objective: CAH and Cloaca are challenging malformations with various surgical techniques in the treatment, including the old Passerine technique and the new TUM technique, which we need to improve our knowledge of the long-term outcomes of patients with rare malformations, and recording of post operative complications will improve the surgical development of the surgical procedure. The aim of this study was to investigate the functional and cosmetic effects and complications of both TUM and Passerine vaginoplasty methods. Materials & Methods: A cohort study in female patients with two malformation Cloaca and CAH in the last 15 years that was carried out at the Tehran Bahrami Pediatric Hospital with two techniques of Passerine and TUM and with referring to patient records, clinical examinations and patient records, clinical examinations and Preoperative cystoscopy examination a post-operative under anesthetic examination , patients' information and complications including urinary incontinence and vaginal stenosis and inappropriate position of vaginal insertion and urethro-vaginal fistula were recorded . Results: 41 patients with an average age of 10.86 years at the time of the study were included in two groups of 20 patients with the old technique (flap) and 21 with a new technique (TUM) in the study. All patients were female. Of the 41 patients, 23 Patients (56.1%) had CAH, and 18 patients (43.9%) had cloaca. The length of the common channel was 2.5 cm in both groups and the mean age of the flap group was 3.7 years and the TUM group was 5.54 years. The mean follow-up of the flap group was 10 years and the TUM was 2.8 years, and the duration of the flap surgery was 3.37 hours TUM is 2.1 hours and the duration of hospitalization is 3.4 days for flap and TUM for 2.2 days. There is a 2.1 significant difference between the three variables of the follow up and the time of operation and the duration of hospitalization between the two techniques with P = 0.001. In two of the complications, vaginal stenosis and inappropriate vaginal position were significantly different between the two groups, with P = 0.001 and P = 0.007 respectively. Conclusions: The findings of the present study indicate that TUM surgery is better in the results and the beauty and proper position of the vagina compared to the passerin method. Less frequent and faster hospital discharge and shorter duration of surgery, with a better appearance and more beauty in the TUM surgery, is one of the characteristics that the findings of this study support.

Keywords

CAH

Cloaca

Passerine technique

TUM

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