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Postoperative anatomical and cosmetic outcomes, and urinary continence, were evaluated.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Out of the 14 cases in this study, 8 were classified as prader IV and 6 as Prader V. The median age at surgery was 11 months (range 6\u201336 months), and the mean urethral length was 1.4\u00a0cm (range 1.2\u20131.8\u00a0cm). The median follow-up period was 4 years. Our cosmetic outcomes were good in 11 (78.5%), satisfactory in 2, and poor in one case. All patients achieved age-appropriate toilet training without urinary incontinence.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Adopting our surgical approach of TUM with modified pull-through vaginoplasty has simplified feminizing surgical reconstruction in CAH cases with severe genital atypia and a very high vaginal confluence with short urethral length, yielding adequate introitus with good anatomical and cosmetic appearance and adequate urinary continence outcomes.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00383-024-05638-8","type":"journal-article","created":{"date-parts":[[2024,3,6]],"date-time":"2024-03-06T14:02:52Z","timestamp":1709733772000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Outcomes of one-stage feminizing genitoplasty in children with congenital adrenal hyperplasia and severe virilization"],"prefix":"10.1007","volume":"40","author":[{"given":"Wael","family":"Abosena","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hisham AlMohamady","family":"Almetaher","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashraf Ahmed","family":"El Attar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed Hassan","family":"Nofal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Essam Abdelaziz","family":"Elhalaby","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,3,6]]},"reference":[{"key":"5638_CR1","doi-asserted-by":"publisher","first-page":"1503","DOI":"10.1210\/jc.2013-3690","volume":"99","author":"H Ostrer","year":"2014","unstructured":"Ostrer H (2014) Disorders of sex development (DSDs): an update. 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