Passerini-glazel feminizing genitoplasty: modifications in 17 years of experience with 82 cases.
OBJECTIVE
To describe modifications of Passerini-Glazel feminizing genitoplasty and report on long-term functional outcome.


METHODS
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.


RESULTS
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.


CONCLUSIONS
These long-term results suggest that our modifications of one-stage Passerini-Glazel feminizing genitoplasty facilitate the procedure and produce good cosmetic results.
Lesma
Arianna
A
Department of Urology, Vita-Salute University, San Raffaele Hospital, Milan, Italy. lesma.arianna@hsr.it
Bocciardi
Aldo
A
Montorsi
Francesco
F
Rigatti
Patrizio
P
D000312:Adrenal Hyperplasia, Congenital / Q000601:surgery*; D012734:Disorders of Sex Development / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D005836:Genitalia, Female / Q000601:surgery*; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000209:etiology; D019651:Plastic Surgery Procedures / Q000379:methods*; D013519:Urogenital Surgical Procedures / Q000379:methods*; D014621:Vagina / Q000601:surgery