Journal of pediatric urology · 2026
Clitoroplasty with corporoplasty in feminizing genitoplasty: Multicenter evaluation of sensory and cosmetic outcomes.
СтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Ошибки и ограничения
История · было → стало
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Massuqueto Eliakim, Venturini Bruna, Moura Ivna Mota Silva de, Oliveira Luciana Mattos Barros, Faria Jose Antonio Diniz, Arruti Renata Andion, Boa Sorte Tatiana Regia Suzana Amorim, Rodrigues Mônica Lima Barbosa, Pinheiro Jennifer Teixeira, Castro Ana Flavia, Costa Juliana de Oliveira Cruz Barreto, Siqueira Isabela Ribeiro, Abreu Mariana Oliveira, Calasans Maria Thais, Bremm Franciele Smiderle, Oliveira Renan Timóteo de, Ramos Yna, de Souza Britto Alissa Fernanda, Tavares Patric Machado, Rosito Tiago Elias, Abreu Glicia Estevam de, Barroso Ubirajara
Аннотация
INTRODUCTION: Disorders of sex development (DSD) are characterized by atypical genital development, with significant physical and psychosocial impact. Feminizing genitoplasty is an important therapeutic option in selected cases, but remains controversial regarding functional preservation, particularly clitoral sensitivity. Corporoplasty is a simplified technique that preserves the corporal bodies and avoids dissection of the neurovascular bundle, prioritizing functional and cosmetic outcomes.
MATERIALS AND METHODS: This multicenter cross-sectional study included 37 female patients with congenital adrenal hyperplasia, classified as Prader II-V, who underwent corporoplasty between 2014 and 2025. Patients with ≥6 months of postoperative follow-up were included. Genital sensitivity was assessed using Semmes-Weinstein monofilaments applied to the clitoris, labia majora, vaginal introitus, and thigh. Cosmetic evaluation was performed by independent pediatric urologists and caregivers. Additional instruments included PedsQL™ and PACE-F.
RESULTS: Median age at surgery was 2.5 years (31.5 months), and median Prader stage was 3 (3-4). Sensitivity thresholds were preserved across all genital regions, with earlier age at surgery significantly associated with better tactile sensitivity (ρ = -0.38 to -0.46; p < 0.05). Median clitoral threshold was 0.07 g (IQR 0.07-0.20), with 59.3 % responding to the lowest filament. No patient reported pain or allodynia. Clitoral variation was perceived by 55.2 % of caregivers. Cosmetic outcomes were rated as good or satisfactory by all physicians (52.9 % and 47.1 %, respectively) and by 90 % of caregivers. Agreement between physicians and caregivers was moderate for clitoral appearance (Kappa = 0.401; p = 0.005). Caregivers reported high satisfaction rates (85.3 %) and low embarrassment (73.5 %), and PedsQL scores were high (median 95).
DISCUSSION: The findings demonstrate that corporoplasty preserves genital sensitivity and has a favorable caregiver-reported psychosocial perception, with high satisfaction among patients and families. The absence of association between of virilization and sensitivity supports the applicability of the technique across different clinical scenarios. The negative correlation between age and sensitivity thresholds supports early surgical intervention. Limitations include relatively short follow-up and lack of assessment of sexual function in adulthood.
CONCLUSION: Corporoplasty suggests being safe, effective, and reproducible, balancing functional preservation, cosmetic outcome, and favorable caregiver-reported psychosocial perception. It represents a promising option for patients with DSD, with early intervention favoring better long-term outcomes. Longitudinal studies are needed to confirm adult functional and quality of life outcomes.
MATERIALS AND METHODS: This multicenter cross-sectional study included 37 female patients with congenital adrenal hyperplasia, classified as Prader II-V, who underwent corporoplasty between 2014 and 2025. Patients with ≥6 months of postoperative follow-up were included. Genital sensitivity was assessed using Semmes-Weinstein monofilaments applied to the clitoris, labia majora, vaginal introitus, and thigh. Cosmetic evaluation was performed by independent pediatric urologists and caregivers. Additional instruments included PedsQL™ and PACE-F.
RESULTS: Median age at surgery was 2.5 years (31.5 months), and median Prader stage was 3 (3-4). Sensitivity thresholds were preserved across all genital regions, with earlier age at surgery significantly associated with better tactile sensitivity (ρ = -0.38 to -0.46; p < 0.05). Median clitoral threshold was 0.07 g (IQR 0.07-0.20), with 59.3 % responding to the lowest filament. No patient reported pain or allodynia. Clitoral variation was perceived by 55.2 % of caregivers. Cosmetic outcomes were rated as good or satisfactory by all physicians (52.9 % and 47.1 %, respectively) and by 90 % of caregivers. Agreement between physicians and caregivers was moderate for clitoral appearance (Kappa = 0.401; p = 0.005). Caregivers reported high satisfaction rates (85.3 %) and low embarrassment (73.5 %), and PedsQL scores were high (median 95).
DISCUSSION: The findings demonstrate that corporoplasty preserves genital sensitivity and has a favorable caregiver-reported psychosocial perception, with high satisfaction among patients and families. The absence of association between of virilization and sensitivity supports the applicability of the technique across different clinical scenarios. The negative correlation between age and sensitivity thresholds supports early surgical intervention. Limitations include relatively short follow-up and lack of assessment of sexual function in adulthood.
CONCLUSION: Corporoplasty suggests being safe, effective, and reproducible, balancing functional preservation, cosmetic outcome, and favorable caregiver-reported psychosocial perception. It represents a promising option for patients with DSD, with early intervention favoring better long-term outcomes. Longitudinal studies are needed to confirm adult functional and quality of life outcomes.