Outcome of feminizing genital reconstruction in female sex assigned disorder of sex development in a low-income country

Ekenze, Sebastian O.; Chikani, Ugo Nnenna; Ezomike, Uchechukwu Obiora; Okafor, David C.

doi:10.1016/j.jpurol.2019.02.021

Cited by 5 publications

(5 citation statements)

References 23 publications

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“…Papers focused on different issues, including challenges faced by patients in accessing surgical care e.g. [ 25 , 35 , 37 ] (including due to COVID-19, [ 57 ]); and performing surgery for complex anomalies [ 37 , 38 ]; the quality of peri- and/or post-operative surgical care (e.g., [ 32 , 33 ]); outcome/survival after surgery (e.g., [ 19 , 89 , 120 ]); and developing cost-effective, local surgical management tools (e.g. management silos for gastroschisis [ 58 ]).…”

Section: Resultsmentioning

confidence: 99%

“…Papers on stigma and related cultural issues (n = 12) were often based on surveys administered to care givers (mostly mothers) of children with CAs and addressed issues such as the influence of stigma on the quality of care (e.g., [ 30 , 34 ]), social/cultural barriers to uptake of preventive measures [ 31 ], prenatal screening [ 116 ] and treatment [ 31 ], genital reconstruction in disorders of sex development [ 120 , 128 ], plastic surgery [ 102 ], community rejection and abandonment by spouse [ 31 , 175 ], as well as health system responsiveness [ 175 ]. Some papers documented family and community beliefs about the causes of CA, e.g., witchcraft, contraception, and the guilt of the mother [ 31 , 116 , 241 ].…”

Section: Resultsmentioning

confidence: 99%

“…Fourteen papers reported on dysmorphology or genetics [ 42 , 56 , 59 , 103 , 120 , 128 , 133 , 170 , 210 , 212 , 224 , 246 , 271 ]. These studies undertook detailed examinations of babies with CA to understand the range of dysmorphologies, and the associations between different anomalies.…”

Section: Resultsmentioning

confidence: 99%

“…One paper focused on ethnic differences in minor anomalies [ 42 ]. Several papers reported the genetic distribution of disorders of sex development [ 59 , 120 , 128 , 224 ].…”

Section: Resultsmentioning

confidence: 99%

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The burden, prevention and care of infants and children with congenital anomalies in sub-Saharan Africa: A scoping review

Leke,

Malherbe,

Kalk

et al. 2023

PLOS Glob Public Health

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The aim of this scoping review was to determine the scope, objectives and methodology of contemporary published research on congenital anomalies (CAs) in sub-Saharan Africa (SSA), to inform activities of the newly established sub-Saharan African Congenital Anomaly Network (sSCAN). MEDLINE was searched for CA-related articles published between January 2016 and June 2021. Articles were classified into four main areas (public health burden, surveillance, prevention, care) and their objectives and methodologies summarized. Of the 532 articles identified, 255 were included. The articles originated from 22 of the 49 SSA countries, with four countries contributing 60% of the articles: Nigeria (22.0%), Ethiopia (14.1%), Uganda (11.7%) and South Africa (11.7%). Only 5.5% of studies involved multiple countries within the region. Most articles included CA as their primary focus (85%), investigated a single CA (88%), focused on CA burden (56.9%) and care (54.1%), with less coverage of surveillance (3.5%) and prevention (13.3%). The most common study designs were case studies/case series (26.6%), followed by cross-sectional surveys (17.6%), retrospective record reviews (17.3%), and cohort studies (17.2%). Studies were mainly derived from single hospitals (60.4%), with only 9% being population-based studies. Most data were obtained from retrospective review of clinical records (56.1%) or via caregiver interviews (34.9%). Few papers included stillbirths (7.5%), prenatally diagnosed CAs (3.5%) or terminations of pregnancy for CA (2.4%).This first-of-a-kind-scoping review on CA in SSA demonstrated an increasing level of awareness and recognition among researchers in SSA of the contribution of CAs to under-5 mortality and morbidity in the region. The review also highlighted the need to address diagnosis, prevention, surveillance and care to meet Sustainable Development Goals 3.2 and 3.8. The SSA sub-region faces unique challenges, including fragmentation of efforts that we hope to surmount through sSCAN via a multidisciplinary and multi-stakeholder approach.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

“…One paper focused on ethnic differences in minor anomalies [ 42 ]. Several papers reported the genetic distribution of disorders of sex development [ 59 , 120 , 128 , 224 ].…”

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

The burden, prevention and care of infants and children with congenital anomalies in sub-Saharan Africa: A scoping review

Leke,

Malherbe,

Kalk

et al. 2023

PLOS Glob Public Health

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“…Although some advocate initiating gender assignment early in childhood, others prefer to reserve this option until the individual reaches gender maturity. [6][7][8] In addition, consideration of foregoing orchiectomy to preserve male hormone levels for our patient was essential due to lack of access to hormonal therapy in this resource-poor setting and balancing this with the risk cancer in the future. Although our patient did experience a delayed diagnosis of OT-DSD, he was greatly satisfied with his surgery.…”

Section: Discussionmentioning

confidence: 99%

Gender Affirmation Surgery for a Delayed Diagnosis of Ovotesticular Disorder of Sexual Development: A Case Report

Kwon

Burks

Kocjancic

et al. 2021

Journal of Gynecologic Surgery

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Background: Ovotesticular disorder of sexual development (OT-DSD) is a rare condition characterized by abnormal gonadal development. Although most OT-DSD is diagnosed during infancy, diagnosis is often delayed or never made in countries with limited resources. Case: A 21-year-old Haitian male presented with gynandromorphic genitalia and breast development, and desired surgical correction of his feminized anatomic features. Physical examination revealed bilateral symmetrical breasts. External genitalia revealed a 7 cm penile-like structure adherent to the ventral aspect of the clitoral hood. A small presumed testis within the scrotum was noted on the right side, whereas the testis and scrotum were absent on the left. Computer tomography of the abdomen and pelvis demonstrated normal kidneys, bilateral ureters, a uterine horn, an intra-abdominal gonad on the left, a descended gonad on the right, and a structure consistent with a vagina. Results: He underwent gender affirmation surgery in two stages: first, an abdominal hysterectomy, left salpingooophorectomy, right trans-scrotal testicular biopsies, and bilateral simple mastectomy, then penile reconstruction and metoidioplasty. The right trans-scrotal biopsy confirmed testicular tissue and left-sided gonad was consistent with ovarian tissue. Traditional cytogenetic analysis revealed 46, XX karyotype. His postoperative course was uncomplicated and 6-month follow-up demonstrated an excellent surgical outcome. Conclusion: Gender affirmation surgery can improve the quality of life of patients who are diagnosed with OT-DSD after puberty. However, access to care continues to be a problem in resource-poor settings and is a major limitation in the treatment.

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Use of Vaginoscopy after Vaginoplasty in Individuals with Congenital Adrenal Hyperplasia

Kamceva,

Strickland,

Gatti

et al. 2024

Journal of Pediatric and Adolescent Gynecology

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Outcome of feminizing genital reconstruction in female sex assigned disorder of sex development in a low-income country

Cited by 5 publications

References 23 publications

The burden, prevention and care of infants and children with congenital anomalies in sub-Saharan Africa: A scoping review

The burden, prevention and care of infants and children with congenital anomalies in sub-Saharan Africa: A scoping review

Gender Affirmation Surgery for a Delayed Diagnosis of Ovotesticular Disorder of Sexual Development: A Case Report

Use of Vaginoscopy after Vaginoplasty in Individuals with Congenital Adrenal Hyperplasia

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