title: Total and partial urogenital mobilization: focus on urinary continence.
abstract: OBJECTIVE
  Total and partial urogenital mobilization procedures are the most common contemporary vaginoplasty surgeries for patients with congenital adrenal hyperplasia, urogenital sinus and cloacal anomalies. There is controversy regarding the urinary continence outcomes of these procedures. We reviewed the urinary continence outcomes of children who underwent total or partial urogenital mobilization at our institution and reviewed the literature to determine the continence rates of these procedures.
  
  
  METHODS
  We retrospectively reviewed 25 patients who underwent total or partial urogenital mobilization with a focus on postoperative continence status. Continence was defined as parental report of full toilet training with no accidents during the day and rare accidents (fewer than 2 per month) at night after age 3 years.
  
  
  RESULTS
  A total of 14 congenital adrenal hyperplasia, 5 urogenital sinus and 6 cloacal anomaly cases were managed by total (18) or partial (7) urogenital mobilization procedures with a mean followup of 4.41 years (range 0.21 to 12.1). In our cohort 21 of 22 patients (95.5%) were continent by age 3 years and there were no urinary complications. A total of 111 patients were identified in the literature with congenital adrenal hyperplasia or urogenital sinus, with 107 in 7 studies being continent (96.4%) by age 3 to 4 years. In 4 studies 32 patients were identified with cloacal anomalies who underwent total or partial urogenital mobilization, of whom 28 (87.5%) were continent by age 3 to 4 years.
  
  
  CONCLUSIONS
  There was no significant difference between total and partial urogenital mobilization procedures regarding postoperative urinary continence in our cohort and the literature. The urinary continence rate was 96% in the congenital adrenal hyperplasia/urogenital sinus group and 89.5% in the cloacal group.
authors.affiliation: Department of Pediatric Urology, University of Oklahoma, Oklahoma City, Oklahoma 73104, USA. blake-palmer@ouhsc.edu
authors.forename: Blake W
authors.initials: BW
authors.lastname: Palmer
authors.forename: Brandon
authors.initials: B
authors.lastname: Trojan
authors.forename: Katie
authors.initials: K
authors.lastname: Griffin
authors.forename: William
authors.initials: W
authors.lastname: Reiner
authors.forename: Amy
authors.initials: A
authors.lastname: Wisniewski
authors.forename: Dominic
authors.initials: D
authors.lastname: Frimberger
authors.forename: Bradley P
authors.initials: BP
authors.lastname: Kropp
mesh_terms: D000312:Adrenal Hyperplasia, Congenital / Q000150:complications / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D002988:Cloaca / Q000002:abnormalities* / Q000601:surgery*; D005260:Female; D006801:Humans; D007223:Infant; D012189:Retrospective Studies; D014549:Urinary Incontinence / Q000209:etiology / Q000517:prevention & control; D013519:Urogenital Surgical Procedures / Q000009:adverse effects / Q000379:methods*