Modified Passerini-Glazel feminizing genitoplasty outcomes in adults: Two rare cases <sup>☆</sup>

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Abstract

Introduction

Modified Passerini-Glazel feminizing genitoplasty is typically performed in children with atypical genitalia. In our article, we have performed the procedure in adults with genital anomalies.

Case presentation

The first case was a 22 years old woman who was planning to get married. She presented with a chief complaint of having no vaginal canal. Gynecological examination showed no vaginal opening. The common channel was visible, and the size of the perineal body was 3 cm. The patient underwent vaginal reconstruction using a modified Passerini-Glazel technique without amnion graft.

The second case was a 20 years old girl planning to get married, with a chief complaint of small vaginal introitus. Gynecology examination showed small minor labia with an introitus size of 1 cm. The patients underwent vaginal reconstruction and labioplasty using a modified Passerini-Glazel technique with an amnion graft.

Both patients have undergone anal atresia surgery in childhood.

Discussion

There was no difference in outcome between using amnion graft and without amnion graft following the modified Passerini-Glazel feminizing genitoplasty procedure. The first patient had been pregnant and had successful delivery by elective cesarean section. Moreover, the second patient had no complaint of sexual disorders after the procedure. No cases of dysuria, urinary tract infection, leukorrhea, hematocolpos, or malodorous vaginal discharge were reported in both cases.

Conclusion

Modified Passerini-Glazel feminizing genitoplasty is a safe and effective procedure. Daily vaginal dilation in the postoperative period was unnecessary, and it allowed for an excellent cosmetic result.

Highlights

•

Genital anomalies after repaired anorectal malformation are rare finding in adults.
•

Modified Passerini-Glazel feminizing genitoplasty procedure is a rare procedure when performed in adults.
•

Both patients had a good outcome after Modified Passerini-Glazel feminizing genitoplasty.

Related collections

Most cited references 7

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The SCARE 2020 Guideline: Updating Consensus Surgical CAse REport (SCARE) Guidelines

Riaz Agha, Thomas Franchi, Catrin Sohrabi … (2020)

The SCARE Guidelines were first published in 2016 and were last updated in 2018. They provide a structure for reporting surgical case reports and are used and endorsed by authors, journal editors and reviewers, in order to increase robustness and transparency in reporting surgical cases. They must be kept up to date in order to drive forwards reporting quality. As such, we have updated these guidelines via a DELPHI consensus exercise.

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A new 1-stage procedure for clitorovaginoplasty in severely masculinized female pseudohermaphrodites.

G Passerini-Glazel (1989)

A new 1-stage procedure for clitorovaginoplasty in severely masculinized female pseudohermaphrodites is presented. The technique consists of clitoral reduction with preservation of the neurovascular supply to the glans and vaginal formation by joining the inverted penile skin and the divided distal "urethra" (urogenital sinus) to form a cylinder that is then inserted into the perineum and anastomosed to the true vagina. For high and small vaginas Monfort's transtrigonal approach is suggested. This operation, 4 of which have been performed to date, can be done at any age, and it offers excellent cosmetic and functional results.

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Passerini-glazel feminizing genitoplasty: modifications in 17 years of experience with 82 cases.

Arianna Lesma, Aldo Bocciardi, Patrizio Rigatti … (2007)

To describe modifications of Passerini-Glazel feminizing genitoplasty and report on long-term functional outcome. Modifications include vaginal dissection and disconnection from the urethrovaginal sinus as the initial stage of the procedure; large dissection of the neurovascular bundle on both dorsal and lateral faces of the clitoris; plication of the skin around the reduced clitoris; and suturing the lateral edge of the proximal portion of the mucocutaneous plate with the labia majora's medial edge to a plane deeper than the subcutaneous tissue. These modifications reduce bleeding and operating time, better preserve clitoral sensitivity, form the clitoral prepuce, and create labia minora. Eighty-two patients underwent modified Passerini-Glazel feminizing genitoplasty. Mean operating time was 120min (range: 100-180). Forty-six patients (46 of 82, 56%) were assessed at a mean follow-up of 5 yr (range: 2-9). There were no cases of clitoral vascularization defect or urethrovaginal fistula. The urethral meatus was never hypospadic. The vaginal introitus was large and elastic in all cases. Vaginal caliber at the internal suture line was as large as the vaginal introitus and the distal native vagina in 20 (43.5%) of the 46 girls. All mothers and patients reported satisfaction with external genital appearance. These long-term results suggest that our modifications of one-stage Passerini-Glazel feminizing genitoplasty facilitate the procedure and produce good cosmetic results.

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Author and article information

Contributors

Roziana

Journal

Journal ID (nlm-ta): Int J Surg Case Rep

Journal ID (iso-abbrev): Int J Surg Case Rep

Title: International Journal of Surgery Case Reports

Publisher: Elsevier

ISSN (Electronic): 2210-2612

Publication date PMC-release: 10 June 2021

Publication date Collection: July 2021

Publication date (Electronic): 10 June 2021

Volume: 84

Electronic Location Identifier: 106086

Affiliations

Urogynecology Division, Department of Obstetrics and Gynecology, Faculty of Medicine, University of Indonesia/Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia

Author notes

[* ]Corresponding author. roziana6682@ 123456gmail.com

Article

Publisher Item ID: S2210-2612(21)00588-5 Publisher ID: 106086

DOI: 10.1016/j.ijscr.2021.106086

PMC ID: 8209187

PubMed ID: 34119936

SO-VID: de78a8ef-7cf4-40dc-bb6d-62b012187668

License:

This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

History

Date received : 19 April 2021

Date revision received : 4 June 2021

Date accepted : 4 June 2021