Lower genital tract lesions requiring surgical intervention in girls: Perspective from a developing country
Article first published online: 14 SEP 2009
© 2009 The Authors. Journal compilation © 2009 Paediatrics and Child Health Division (Royal Australasian College of Physicians)
Journal of Paediatrics and Child Health
Volume 45, Issue 10, pages 610–613, October 2009
How to Cite
Ekenze, S. O., Mbadiwe, O. M. and Ezegwui, H. U. (2009), Lower genital tract lesions requiring surgical intervention in girls: Perspective from a developing country. Journal of Paediatrics and Child Health, 45: 610–613. doi: 10.1111/j.1440-1754.2009.01574.x
- Issue published online: 7 OCT 2009
- Article first published online: 14 SEP 2009
- Accepted for publication 31 March 2009.
- developing country;
- female circumcision;
- vulval disorder
Aim: To determine the spectrum, outcome of treatment and the challenges of managing surgical lesions of lower genital tract in girls in a low-resource setting.
Method: Retrospective study of 87 girls aged 13-years and younger, with lower genital tract lesions managed between February 2002 and January 2007 at the University of Nigeria Teaching Hospital, Enugu, southeastern Nigeria. Clinical charts were reviewed to determine the types, management, outcome of treatment and management difficulties.
Results: The median age at presentation was 1 year (range 2 days–13 years). Congenital lesions comprised 67.8% and acquired lesions 32.2%. The lesions included: masculinised external genitalia (24), vestibular fistula from anorectal malformation (23), post-circumcision labial fusion (12), post-circumcision vulval cyst (6), low vaginal malformations (6), labial adhesion (5), cloacal malformation (3), bifid clitoris (3) urethral prolapse (3), and acquired rectovaginal fistula (2). Seventy-eight (89.7%) had operative treatment. Procedure related complications occurred in 19 cases (24.4%) and consisted of surgical wound infection (13 cases), labial adhesion (4 cases) and urinary retention (2 cases). There was no mortality. Overall, 14 (16.1%) abandoned treatment at one stage or another. Challenges encountered in management were inadequate diagnostic facilities, poor multidisciplinary collaboration and poor patient follow up.
Conclusion: There is a wide spectrum of lower genital lesion among girls in our setting. Treatment of these lesions may be challenging, but the outcome in most cases is good. High incidence of post-circumcision complications and poor treatment compliance may require more efforts at public enlightenment.