Operations of such complexity are performed in Ukraine only by pediatric urologists of the regional “Okhmatdyt” and only a few clinics in Europe.
Doctors performed a complex reconstructive and plastic surgery on a 13-year-old girl with a severe congenital malformation of the endocrine and genitourinary systems. The operation lasted eight hours.
The child was diagnosed with congenital hyperplasia of the adrenal cortex, salt-losing form. From birth, she suffered not only from severe hormonal and water-electrolyte disorders in the body, but also from an incorrect structure of the urinary and genital systems, their joint fusion into a single, common, thin tube, which disturbed the work of both systems.
The cause of congenital hyperplasia of the adrenal glands is a violation of the formation of steroid hormones by the adrenal glands due to a deficiency of enzymes. One of the consequences of this imbalance is the excessive production of male sex hormones – androgens, which provoke severe anatomical changes in the child’s body.
Doctors performed a number of high-tech examinations – CT scan, genitoscopy, urethrocystoscopy, colposcopy, genetic and special laboratory examinations. To develop an effective conservative and, later, surgical correction, highly professional and coordinated work of many specialists was necessary – geneticists, pediatric endocrinologists, pediatric gynecologists, pediatric urologists.
As a result of the first conservative stage of therapy, the water-salt exchange was corrected, which made it possible to normalize the development of the internal genital organs of the child.
The purpose of the highly complex eight-hour surgical intervention was to disconnect the urinary and genital systems with the restoration of the “female” anatomy and the possibility of a full life in the future. In addition, an important result was a reduction in the risk of urological complications, such as infections or urinary incontinence, a reduction in the risk of genital cancer, and ensuring full social adaptation.
The long surgical intervention was successful. The girl’s parents note a significant improvement in her emotional and psychological state.
The operating team consists of urologists Andriy Potsyurko, Igor Hrymak, Danylo Ivaskevich, Roman Potsyurko, gynecologist Elina Chaykivska, and anesthesiologist Vira Pryimakova.
Operative interventions of this level of complexity in these patients have been carried out in the Lviv Regional Clinical Children’s Hospital “Okhmatdyt” for the past six years. The results were reported at scientific medical conferences in Ukraine and European congresses of pediatric surgeons and urologists.