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S5-9
(P)
PERINEAL ULTRASOUND (PU) DETECTS URETHRAL AND VAGINAL ANOMALIES IN
CAH
Lutz WUENSCH, Judith LINDERT, Ludger TUESHAUS and Kianusch TAFAZZOLI-LARI
University of Lübeck, Paediatric Surgery, Lübeck, GERMANY
PURPOSE
In girls with CAH, urethral and vaginal anatomy varies considerably. Before surgery, the length of the common channel
and the length of the bladder neck must be known in order to select an appropriate surgical approach. This information
has traditionally been obtained from endoscopy, genitography or MRI. In this study, we explored the feasibility and
accuracy of perineal ultrasound for this purpose.
MATERIAL AND METHODS
PU was carried out in 8 girls with CAH. Inverted longitudinal sections were obtained and compared to endoscopic
findings of the same patients obtained preoperatively and to ultrasound findings from normal girls. The length of the
common channel was measured endoscopically and compared to the ultrasound findings.
RESULTS
Ultrasound reliably distinguished normal patients from patients with CAH. It visualized the urethra, bladder neck and
vagina as well as the common channel and the bulbospongiosus muscle in CAH. Measurements of bladder neck and
common channel length were comparable with both techniques.
CONCLUSIONS
PU is a simple and cheap technique that reliably provides anatomic details of surgical importance in CAH. It may help to
avoid the radiation exposure associated with genitography and the cost associated with endoscopy or MRI. The
technique is easily repeated and is particularly suitable for follow-up examinations. PU should be considered the first line
investigation in patients with CAH. Many surgeons are familiar with ultrasound and may take advantage of this
technique.