A Surgeon’s Perspective

I had the opportunity to share this case report suggesting vaginoplasty may be easier at puberty with several pedaitric urologists. Brad Kropp, of the University of Oklahoma, had the following to say:

Interesting case report.  The images are very interesting.  When I look at the vaginogram at 3 months you see a very small vagina. The MRI, years later, then demonstrates a large fluid (most likely urine) filled vagina and uterus.  I would propose that the vagina is closer to the perineum because the chronic vaginal distention that occurred from the retained urine in both the vagina and uterus.  I have seen this same picture on several of the cloacal kids prior to my reconstruction that develop this type of distention.  There is no doubt that a large vagina is easier to work with but I would be interested to know how many UTI’s and problems this child had because of the chronic distention and retention of urine.