PMID: 9165458May 1, 1997Paper

Anterior sagittal transanorectal approach to the urogenital sinus in adrenogenital syndrome: preliminary report

Journal of Pediatric Surgery
R DòminiRoberto de Castro

Abstract

In the female adrenogenital syndrome, the treatment of the urogenital sinus with high implanted vagina still presents a surgical challenge. The conventional technique (perineal vaginal pull-through) has been plagued by a high incidence of vaginal stenosis. A posterior sagittal transanorectal approach was proposed as an alternative to obtain an excellent exposure and thus an adequate mobilization of the vagina. But bivalving a normal rectum and anus has the potential for compromising bowel control and represents a bold maneuver, and the rectum and sphincteric mechanism must be meticulously reconstructed. In the original procedure a protective colostomy must be performed before the operation. To reduce these disadvantages, the authors made the following modifications: sagittal incision of only the anterior rectal wall (Anterior Sagittal Transanorectal Approach--ASTRA) and protective colostomy at the same time as the operation. In this way, maintaining the same excellent exposure and reducing the number of operations from three to two, we operated on 10 girls with adrenogenital syndrome: 4 with high, 3 with intermediate urogenital sinus, and 3 who had previously undergone vaginal pull-through but experienced a vaginal retraction w...Continue Reading

References

Jun 1, 1992·Journal of Pediatric Surgery·A PeñaC Stolar
Apr 1, 1990·The Journal of Urology·R Gonzalez, E T Fernandes
Sep 1, 1984·Annals of Surgery·P K Donahoe, W H Hendren
Feb 1, 1995·Journal of Pediatric Surgery·D M PowellJ Randolph

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Citations

Nov 2, 2004·Pediatric Surgery International·A Pini PratoV Jasonni
Oct 31, 2006·Pediatric Surgery International·Andras PinterZsolt Oberritter
Jan 29, 2002·Surgery·Zoltan Hrabovszky, John M Hutson
Jul 3, 2008·World Journal of Urology·A SavanelliA Settimi
Mar 14, 1998·Seminars in Pediatric Surgery·M Reynolds
Nov 14, 2012·Journal of Pediatric Urology·Sarah CreightonJoao Pippi Salle
Jan 8, 2000·Journal of Pediatric Surgery·M DòminiR Dòmini
Mar 22, 2000·Journal of Pediatric Surgery·M DòminiR Dòmini
Jul 3, 2013·International Journal of Surgery Case Reports·Mila Torii Corrêa LeiteJosé Luiz Martins
Feb 14, 2007·The Journal of Urology·Roberto De CastroAntonio Macedo
Jun 17, 2000·Endocrine Reviews·P C White, P W Speiser
Aug 1, 2019·Endocrine Reviews·Amy B WisniewskiBerenice B Mendonca

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