Clitoroplasty and Urogenital Sinus Mobilization in Females with Congenital Adrenal Hyperplasia: A Case Report with Focused Literature Discussion.

INTRODUCTION Congenital adrenal hyperplasia (CAH) can result in masculinized genitalia due to excessive androgen production. This genital virilization often presents as clitoral hypertrophy, ranging from a significantly enlarged clitoris to a phallic-like clitoris in female patients.

CASE PRESENTATION A Syrian refugee girl presented at age 24 with complaints of abnormal genitalia. Gynecologic examination revealed clitoromegaly, absence of labia minora, and a single common orifice of the urethra and vagina, the size of a pinhead. Nerve-sparing clitoroplasty, total urogenital sinus mobilization, vaginoplasty, and creation of labia minora with perineoplasty were performed.

CONCLUSIONS There are limited case reports on CAH, clitoroplasty, and urogenital sinus mobilization in adults. This case highlights the feasibility of one-stage feminizing genitoplasty in adulthood and provides unique educational value through detailed step-by-step surgical video documentation.