UCL Discovery
UCL home » Library Services » Electronic resources » UCL Discovery

Gynaecological and psychosexual outcomes of feminising genital surgery.

Crouch, N.S.; (2007) Gynaecological and psychosexual outcomes of feminising genital surgery. Doctoral thesis , University of London. Green open access

[thumbnail of U592803 Redacted.PDF]
Preview
Text
U592803 Redacted.PDF

Download (15MB) | Preview

Abstract

Childhood feminising surgery remains standard clinical practice for those born with ambiguous genitalia, such as women with Congenital Adrenal Hyperplasia (CAH). The aims of such an intervention are to promote "normal" female appearance, allow comfortable penetrative intercourse with unimpaired sensation, avoid increased psychological sequelae and prevent urinary difficulties due to anatomical variations. However, these aims remain largely unevaluated. Little is known about the range of normal female genital appearance with few objective measurements in the literature. Scanty long-term data is available regarding sexual function and sensation following childhood feminising surgery. To date there is no evidence to suggest that childhood surgery reduces psychological distress compared with those who did not have operations. Finally, no studies are available assessing urinary outcomes following surgery. These areas are assessed in turn, starting with a study to ascertain normal female appearance of the genital area, and to illustrate the variations of normality. Genital sensation is next considered, with a study of 28 women with CAH who underwent objective sensation testing to the clitoris, where surgery had taken place, and to the upper vagina, where no operations had been performed. This data was compared with 9 normal subjects who had no history of sexual function difficulties or previous operations to the genital area. Clitoral sensation was significantly impaired in those who had undergone surgery, but not vaginal sensation. Sexual function and subjective views regarding surgery were assessed, with 32 women with CAH recruited to complete a detailed questionnaire assessing various aspects of anatomical and psychosexual function. This was then compared with data from 10 normal controls, showing women with a history of surgery had increased sexual function difficulties. Finally, a further study assessed the degree of lower urinary tract symptoms in those who had undergone surgery, and compared this with a normal control group. This showed increased urinary tract symptomatology in the group who had undergone childhood surgery. The results of these studies are discussed and considered in the context of current knowledge of intersex research. Recommendations for clinical practice and future research are given.

Type: Thesis (Doctoral)
Title: Gynaecological and psychosexual outcomes of feminising genital surgery.
Identifier: PQ ETD:592803
Open access status: An open access version is available from UCL Discovery
Language: English
Additional information: Thesis digitised by Proquest Third party copyright material has been removed from the e-thesis.
UCL classification: UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL EGA Institute for Womens Health
URI: https://discovery.ucl.ac.uk/id/eprint/1445481
Downloads since deposit
484Downloads
Download activity - last month
Download activity - last 12 months
Downloads by country - last 12 months

Archive Staff Only

View Item View Item