PMC4959403_01
(a) Hypertrophied clitoris (black arrow), flat perineum (white arrow), and vaginal orifice (blue arrow). (b) Black dotted mark represents incision. Inset showing preoperative anatomy. U: Urinary bladder, V: Vagina, R: Rectum, Du: Dorsal urethra (red color), Vu: ventral urethra
JSTCR-7-1-g001.jpg
PMC4959403_01_JSTCR-7-1-g001.jpg
F1
No scrotal or labial structures were present and the perineum appeared flat and fused [Figure 1]. Urethrogram and genitogram were done under fluoroscopy and delineated the anatomy, suggestive of UD [Figure 1, Inset].
(a) Distal dorsal urethra (black arrow) and proximal dorsal urethra (white arrow). The vagina (blue arrow) and its confluence (yellow arrow) with the ventral urethra. (b) Feminizing genitoplasty (black arrow). Soft tissue interposition (white arrow) in between the repaired vagina and urethra. Inset showing postoperative anatomy
JSTCR-7-1-g002.jpg
PMC4959403_01_JSTCR-7-1-g002.jpg
F2
The proximal portion of the dorsal urethra was well developed (good caliber), joined to the ventral urethra near its confluence into the vagina [Figure 2a]. The rent in the anterior vaginal wall and ventral urethra was repaired and soft tissue interposed in between the two suture lines [Figure 2b]. The distal continuity of the ventral urethra with the dorsal urethra (good caliber) was maintained and neourethra (i.e., proximal part consisted of the ventral urethra and the distal part consisted of the dorsal urethra) reconstructed [Figure 2].