الفهرس 
Disorders of Sex DevelopmentOnly 14 pages are availabe for public view
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Abstract
CAH cases could be managed safely by single stage feminizing genitoplasty just after correction of metabolic and endocrinological disturbances. 2. Correction of CAH at an early age solves the problem and avoid the psychological burden of both the parents and the patients. 3. Functional outcomes of CAH feminizing genitoplasty could not be fully appreciated except after reaching pubertal age and starting sexual marital life. 4. Continuous medical surveillance linked to the treatment in cases of CAH is essential to prevent complications and relapse and its hazardous effect on outcomes of surgery e.g. vaginal stenosis and enlarged clitoris especially on the long term. 5. Lack of vaginal dilatation and sexual intercourse for CAH cases may contribute to late postoperative vaginal stenosis. 6. Vaginoplasty using P.U.M is associated with excellent cosmetic appearance with easy cathetrizable urethra and visible vaginal orifice as well as good urological outcomes with low to intermediate UGS confluence. 7. Post genitoplasty late introital vaginal stenosis in CAH cases could be corrected safely surgically on the short-term but we still need long term follow up for those cases 8. Fixation of neovagina in cases operated with sigmoid vaginoplasty is a must to prevent neovaginal prolapse 9. Fashioning of the sigmoid flap length in cases of sigmoid vaginoplasty to be not too long and not too short is important for prevention of postoperative complications Conclusions & Recommendations 160 10. Excessive mucus and malodour following sigmoid vaginoplasty are a troublesome and preoperative counselling with the patient and their parents is a must. 11. Diagnostic tools used in cases of vaginal atresia cases as US, MRI, diagnostic cystoscopy and diagnostic laparoscopy are very beneficial in diagnosis of the case and possible associated urological anomalies with great role for laparoscopy in evaluation of internal genital organs over MRI before definitive corrective surgery RECOMMENDATIONS 1. Long term follow-up is important in cases of CAH and in sigmoid vaginoplasty cases especially after getting married and starting their sexual life. 2. Multicenter studies of D.S.D and Mullerian anomalies are needed to overcome the drawbacks of small number of cases due to relatively rare incidence of those cases. 3. Multidisciplinary team approach for management of CAH is very important before and after the surgery. 4. Early repair of CAH cases is recommended for surgical, social and psychological causes 5. Long term follow-up of genital anomalies associated with operated bladder exstrophy in female cases is important as early detection and correction of theses anomalies will improve the quality of life of the patient and improve her sexual life and increase her chance for fertility