title: [Sigmoid neovagina: apropos of 2 cases].
abstract: The presence of ambiguous external genitals can be related with a number of nosologic entities. We can find the female form with hypertrophic clitoris and vaginal hypoplasia in a wide variety of phenotype presentations. We have two young girls with ambiguous external genitals, where we notice hypertrophic clitoris and vaginal hypoplasia, with the diagnosis of mixed gonadal dysgenesis and androgen insensitivity syndrome (Morri's Syndrome). They have been operated several times: gonadectomy, genitoplasty, vaginoplasty and mammoplasty. We have made a neovagina, using a segment of sigma and preserving the walls of the former vagina. The surgical technique we used, consisted in the abdominoperineal descent of the segment of sigmoid colon and anastomosis with the back wall of the former vagina and the perineum; after that, we split the intervaginal septum, linking these two structures and reaching a lonely introitus vaginae. The hormonal treatment for the girl with mixed gonadal dysgenesis with estrogen and progestogen induces normal menstruations; we only use estrogen for the patient with Morri's Syndrome. The histology showed that there were dysgenetic gonads in one of the patients and testicular tissue without gonadal elements. Both girls have had a good evolution, with no problems and an excellent aesthetic and functional result.
authors.affiliation: Servicio de Cirugía Pediátrica, Hospital Infantil Gregorio Marañón, Madrid.
authors.forename: R
authors.initials: R
authors.lastname: Sánchez-Martín
authors.forename: E
authors.initials: E
authors.lastname: Molina
authors.forename: J
authors.initials: J
authors.lastname: Cerdá
authors.forename: J A
authors.initials: JA
authors.lastname: Navascués
authors.forename: G
authors.initials: G
authors.lastname: Barrientos
authors.forename: R
authors.initials: R
authors.lastname: Romero
authors.forename: J
authors.initials: J
authors.lastname: Vázquez
mesh_terms: D000293:Adolescent; D013734:Androgen-Insensitivity Syndrome / Q000601:surgery*; D012809:Colon, Sigmoid / Q000637:transplantation*; D015914:Estrogen Replacement Therapy; D005260:Female; D005500:Follow-Up Studies; D006060:Gonadal Dysgenesis, Mixed / Q000601:surgery*; D020249:Hormone Replacement Therapy; D006801:Humans; D008297:Male; D011372:Progestins / Q000627:therapeutic use; D013997:Time Factors; D014621:Vagina / Q000002:abnormalities* / Q000601:surgery*
chemical_list: D011372:Progestins