Aplicación de los colgajos fasciocutáneos vulvoperineales en cirugía pediátrica: a propósito de un caso / Application of vulvoperineal fasciocutaneous flaps in pediatric surgery: case report

La incidencia de agenesia de vagina es de 1/4000-10000 recién nacidas vivas. La causa más frecuente es el síndrome de Mayer-Rokitansky-Küster-Hauser. Presentamos un caso de reconstrucción vaginal con colgajos fasciocutáneos vulvoperineales de Málaga en una paciente pediátrica afecta de este síndrome, describiendo los pasos del procedimiento y las bases anatómicas en las que se fundamenta. Esta técnica permite la creación de una neovagina sensible, con una cobertura de excelente calidad, con un ángulo de inclinación fisiológico y natural y unaxis anatómico correcto para la relación sexual; se realiza en un solo tiempo quirúrgico y con mínima morbilidad para la paciente. Su principal inconveniente es el crecimiento de pelo dentro de la vagina, aunque se atenúa con el tiempo debido a un fenómeno de atrofia folicular y metaplasia cutánea (AU)

The incidence of vaginal agenesis is 1/4000-10000female alive newborns. The most frequent cause is Mayer-Rokitansky-Küster-Hauser syndrome. A technique for vaginal reconstruction using the vulvoperineal fasciocutaneous flaps (Malaga flaps) in a pediatric patient affected of this syndrome is presented, describing the steps of the procedure and its anatomic basis. This technique allows the reconstruction of an excellent quality and sensible neovagina, with aphysiologic inclination angle which allows the sexua lintercourse, in one single stage operation and with minimal morbidity. The main inconvenient of this procedure is the hair growth inside the vagina, although it diminishes with the passage of time due to follicular atrophy and cutaneous metaplasy (AU)

[Puberal gynaecomastia. Review of nine cases]. / Ginecomastia puberal. Revisión de nueve casos.

Gynaecomastia is more frequent during the adolescence. In this paper, a retrospective study of nine cases diagnosed and treated on a period of six years is presented. The reports of nine patients are reviewed. The mean age at diagnosis was 10.4 years (range 9-12). In all cases a bilateral mammary hypertrophy was detected, symmetrical in 6 cases (67%) and asymmetric in 3 (33%). After a mean follow-up period of 24 months, surgical treatment was indicated: a subtotal subcutaneous mastectomy was performed in all nine cases. Only two patients developed early complications: one wound infection and one haematoma. The long-term plastic results were satisfactory after a mean follow-up postoperative period of 11 months. The general management of this kind of pathologic process is presented. In the authors experience the elective surgical procedure is the subtotal subcutaneous mastectomy as simple procedure with a very short morbidity and excellent plastic results.