SURGICAL INTERVENTIONS FOR UROGENITAL MALFORMATIONS IN CHILDREN WITH CONGENITAL ADRENAL HYPERPLASIA: CHALLENGES IN PEDIATRIC UROLOGICAL MANAGEMENT

Abstract

Introduction: Congenital adrenal hyperplasia (CAH) is a genetic disorder that affects hormone production by the adrenal glands, resulting in disturbances in urogenital development, especially in female children. These malformations can lead to physical and emotional complications, requiring surgical interventions to correct anatomical anomalies and restore adequate urological function. Pediatric urological management in this context presents significant challenges, including the need for a multidisciplinary approach and the impact of interventions on the quality of life of affected children. Objective: To analyze surgical interventions performed in children with urogenital malformations resulting from congenital adrenal hyperplasia, evaluating complications, functional outcomes, and postoperative quality of life. Methodology: The research followed the PRISMA checklist guidelines and covered articles published in the last 10 years in the PubMed, Scielo, and Web of Science databases. Five descriptors were used: Defects of sexual development (DSD), Virilism, Genital ambiguity, Hydrocele and Cryptorchidism. The inclusion criteria were: studies that addressed surgical interventions in pediatric patients with CAH, articles that reported postoperative clinical outcomes and studies that discussed post-intervention psychosocial aspects. Exclusion criteria included non-peer-reviewed publications, studies focusing on adults and studies that did not present relevant clinical data. Results: The analysis revealed that the most common surgical interventions included corrections of anatomical anomalies and urogenital reconstructions. Complications ranged from infections to the need for revision surgeries. Most studies highlighted the importance of psychological support in the postoperative period, with a significant impact on the quality of life of children. Conclusion: Surgical interventions for urogenital malformations in children with congenital adrenal hyperplasia were essential to improve urological function and quality of life. Despite the associated challenges, a multidisciplinary approach has proven crucial for effective management, emphasizing the need for ongoing support for the physical and emotional health of affected children.