Sexual function in adult life following Passerini-Glazel feminizing genitoplasty in patients with congenital adrenal hyperplasia.
OBJECTIVE
We assessed external genitalia sensitivity and sexual function in adults with congenital adrenal hyperplasia who had undergone Passerini-Glazel feminizing genitoplasty as children, and compared them to a control group of healthy counterparts.


METHODS
Inclusion criteria were congenital adrenal hyperplasia, Passerini-Glazel feminizing genitoplasty, adult age and penetrative vaginal intercourse. Thermal and vibratory sensitivity of the clitoris, vagina and labia minora were analyzed using the Genito Sensory Analyzer (Medoc Ltd., Minnetonka, Minnesota). Psychosexual outcome was assessed with the Beck Depression Inventory, Zung Self-Rating Anxiety Scale, Female Sexual Distress Scale and Female Sexual Function Index. Matched analyses were performed to compare outcomes in patients to controls (healthy medical students). All statistical tests were performed using SPSS®, version 18.0 RESULTS: A total of 12 patients (10%) entered the study. Thermal and vibratory clitoral sensitivity was significantly decreased in all patients compared to healthy controls (p <0.01). There was no difference in thermal or vibratory vaginal sensitivity between patients and controls. On the Female Sexual Distress Scale 11 patients (91.6%) and 11 controls (91.6%) described a stable satisfactory relationship. All patients reported active sexual desire, good arousal, adequate lubrication and orgasm. No significant difference in Female Sexual Function Index global score or single domain scores was observed between patients and controls.


CONCLUSIONS
Although clitoral sensitivity in sexually active patients with congenital adrenal hyperplasia treated with Passerini-Glazel feminizing genitoplasty is significantly reduced compared to controls, sexual function in those patients is not statistically or clinically significantly different from their healthy counterparts. Finally, 1-stage Passerini-Glazel feminizing genitoplasty seems to allow normal adult sexual function.
Department of Urology, San Raffaele Scientific Institute, Vita-Salute University, Milan, Italy.
Arianna
A
Lesma
Department of Urology, Niguarda Ca'Granda Hospital, Milan, Italy.
Aldo
A
Bocciardi
Department of Urology, San Raffaele Scientific Institute, Vita-Salute University, Milan, Italy. Electronic address: stefano.corti85@libero.it.
Stefano
S
Corti
Department of Pediatrics, San Raffaele Scientific Institute, Vita-Salute University, Milan, Italy.
Giuseppe
G
Chiumello
Department of Urology, San Raffaele Scientific Institute, Vita-Salute University, Milan, Italy.
Patrizio
P
Rigatti
Department of Urology, San Raffaele Scientific Institute, Vita-Salute University, Milan, Italy.
Francesco
F
Montorsi
D000312:Adrenal Hyperplasia, Congenital / Q000150:complications* / Q000601:surgery; D000328:Adult; D012734:Disorders of Sex Development / Q000209:etiology / Q000503:physiopathology / Q000523:psychology / Q000601:surgery*; D005260:Female; D006801:Humans; D019651:Plastic Surgery Procedures; D019529:Sexuality; D013696:Temperature; D014110:Touch; D014621:Vagina / Q000033:anatomy & histology / Q000503:physiopathology / Q000601:surgery; D014732:Vibration; D014844:Vulva / Q000033:anatomy & histology / Q000294:innervation / Q000503:physiopathology / Q000601:surgery; D055815:Young Adult
BDI; Beck Depression Inventory; CAH; FSFI; Female Sexual Function Index; GSA; Genito Sensory Analyzer; SAS; Self-Rating Anxiety Scale; adrenal hyperplasia; congenital; congenital adrenal hyperplasia; disorders of sex development; female; genitalia; plastic; surgery; urogenital surgical procedures