Urinary Tract Infection after Surgical Correction of Female Patients with Congenital Adrenal Hyperplasia

Ateya, Mohamed Ahmed; Arafa, Noha; Hafez, Mona Hassan; Morsi, Hani; Shouman, Ahmed M

doi:10.21608/ejhm.2023.283666

Urinary Tract Infection after Surgical Correction of Female Patients with Congenital Adrenal Hyperplasia

Document Type : Original Article

Authors

10.21608/ejhm.2023.283666

Abstract

Background: Congenital adrenal hyperplasia (CAH) is the most common cause of virilized females with disorders of sexual differentiation (DSD) with46XX karyotype.
Objective: To prospectively investigate the correlation between surgical correction using single surgical technique (partial urogenital sinus mobilization) and the occurrence of urinary tract infection in female patients with congenital adrenal hyperplasia (CAH). Methods: Our study included 27 CAH female patients who follow up in urology and endocrinology clinic in Cairo university hospitals. We prospectively followed the patients over a period of 4 years. Prader grade of virilization of the patients ranged from II to V. Before surgical correction patients were assessed by filling questionnaire by their parents, doing urine analysis and urine culture. Postoperative assessment by same tools was done after one month, then every three months. Follow up period extended from 26 to 42 months. Results: Two patients were classified as Prader type two (7.4%), ten patients as Prader type III (37.1 %), thirteen patients as Prader type IV (48.1%) and two patients as Prader type V (7.4%). All patients were well controlled before surgery with preoperative 17- OH progesterone ranging from 0.16 to 6 ng/dl (Mean ±SD: 1.532 ±1.77). All patients had negative preoperative urine cultures for infection .Postoperative urine analysis and cultures were positive for infection in seven patients (25.9%) after one month of surgery.
Conclusions: Long term urinary tract infection rates don’t increase after surgical reconstruction of female patients with partial urogenital sinus mobilization even If early postoperative urinary tract infection rates were high.

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