Search Results (2)

Background and Objectives: Persistent urogenital sinus (PUGS) is a rare congenital anomaly resulting from disruptions in urogenital development during embryogenesis. Characterized by the confluence of the vaginal canal and urethra into a single channel, it poses diagnostic and management challenges, particularly in adult patients. Surgical correction remains the primary treatment at an early age, yet there are no universally accepted guidelines regarding treatment at later stages in life. We explored current evidence on the management of high urogenital sinus (HUGS) in adults, focusing on surgical techniques, outcomes, perioperative care, and follow-up. Materials and Methods: A scoping review was conducted using PubMed, Scopus, and Google Scholar, including studies published up to August 2024. Search terms included “high urogenital sinus”, “adult patients”, and related conditions. Articles were included if they addressed clinical, diagnostic, or therapeutic data on HUGS in adult populations. Data extraction was performed independently by two reviewers, and a PRISMA-ScR flow diagram was used to outline the study selection process. Results: Nine studies met inclusion criteria, with data on surgical techniques, perioperative care, and long-term outcomes extracted for analysis. The included studies highlighted diverse surgical approaches, such as feminizing genitoplasty, buccal mucosa vaginoplasty, posterior prone techniques, and robotic-assisted urogenital sinus mobilization. Complications like vaginal stenosis, urethrovaginal fistula, and urinary incontinence were reported. Long-term outcomes were under-reported, with limited data on sexual function and patient satisfaction. Hormonal therapies, including glucocorticoids, played critical roles in managing cases associated with congenital adrenal hyperplasia (CAH). Conclusions: The management of HUGS requires a multidisciplinary approach integrating advanced surgical techniques and individualized perioperative care. While short-term outcomes are generally favorable, long-term data on sexual function and quality of life remain scarce. Future research should prioritize longitudinal studies to address these gaps, aiming to optimize surgical outcomes, patient satisfaction, and psychosocial well-being. Full article

Gynecological fistulae are a rare but severe complication of radiation therapy, pelvic surgery, prolonged labor, cesarean deliveries, or inflammatory bowel diseases. A gynecological fistula is an abnormal pathway formed between the urinary and gynecological tract, most commonly located between the urinary bladder and vagina. Vesico-uterine and vesicovaginal fistulae are an important health issue, common in women of reproductive age in developing countries with limited access to obstetrical care. Various surgical techniques have been described for VVF repair, depending on the location, severity, and cause of the fistula and the surgeon’s experience. The purpose of our review was to evaluate the present state of knowledge about the prevalence and treatment of gynecological fistulae. The PubMed scientific database was searched for original articles on the subject of gynecological fistulae that had been published between 2013 and 2023. Full article