[Role of pediatric urologist in the treatment of congenital adrenal hyperplasia: a study of satisfaction and psychosocial aspects].
OBJECTIVE
Study the role of the pediatric urologist in the treatment of CAH and the satisfaction of families and patients to identify the psychosocial aspects that we can improve.


METHODS
Retrospective study in girls with CAH treated in our center. We reviewed the medical records, analyzing the variables: place of birth, age at diagnosis, surgery, complications and follow up. Analysis of satisfaction and psychosocial aspects by telephone survey.


RESULTS
Between 1975-2011, 25 girls with CAH have been treated in our center. Cystoscopy and vaginoscopy was performed before clitoroplasty in 68% (16 girls), adding vulvovaginoplasty in 40% and vaginal descent in the 20%. The mean age was 8.78 +/- 2.30 months. Vaginal stenosis was the main complication (36%), performing introitus plasty in two girls, vaginal expansion in other 2 and dilation of the rest. 15 surveys were made, all expressed satisfaction with treatment, and only 6.67% reported shortages information. With the aesthetic results of the genitoplasty 20% showed dissatisfaction. The family concern was constant at 60%, and sporadic in the rest. 13.3% required psychological support. Currently 80% have normal psychosocial life.


CONCLUSIONS
The HSC requires a multidisciplinary approach right from birth to allow adequate psychosocial development. The pediatric urologist has an important weight in the multidisciplinary treatment. Realizing early feminizing genitoplasty decreases family impact and increases satisfaction. The prolonged follow-up will allow the detection and treatment of complications.
Servicio de Urología Pediátrica, Hospital Virgen del Rocío, Sevilla. yoli84mc@hotmail.com
Y
Y
Martínez-Criado
A L
AL
Gómez
M A
MA
Fernández-Hurtado
R
R
Barrero
F
F
García-Merino
D000312:Adrenal Hyperplasia, Congenital / Q000523:psychology* / Q000601:surgery*; D002648:Child; D005260:Female; D006801:Humans; D017060:Patient Satisfaction; D010372:Pediatrics; D010819:Physician's Role; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D014572:Urology