Pediatric andrology

The surgical treatment of ambiguous genitalia has undergone major changes both in technique and in results since the introduction of the Passerini Glazel genitoplasty in 1989. In this study we review our institution's results with 41 patients since 1989. 13 patients underwent a modified procedure because of previous attempts at genitoplasty and 28 underwent the standard Passerini Glazel procedure. We describe the technique in its 4 major operative steps: 1) dissection of the urethra; 2) dissection of the vagina; 3) clitoroplasty; 4) formation of the neointroitus. Follow-up was 7 years 3 months to 13 months (mean 4 years 2 months) for the original technique and 7 years 4 months to 20 months (mean 4 years 11 months) for the modified procedure. In the 28 operated on with the classic procedure 1 developed a urethro-vaginal fistula requiring reoperation while in 13 who underwent the modified procedure 3 developed infundibular strictures requiring Y-V flap revision. The final results in all cases were aesthetically excellent and gave satisfaction to patients and family. We conclude that the Passerini Glazel feminizing genitoplasty is a safe and effective procedure with excellent long term results.