{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T18:09:01Z","timestamp":1791828541146,"version":"4.3.4"},"reference-count":37,"publisher":"The Endocrine Society","issue":"11","funder":[{"DOI":"10.13039\/100005709","name":"Endocrine Society","doi-asserted-by":"publisher","award":["na"],"award-info":[{"award-number":["na"]}],"id":[{"id":"10.13039\/100005709","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,11,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Females with congenital adrenal hyperplasia (CAH) and atypical genitalia often undergo complex surgeries; however, their outcomes remain largely uncertain.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We searched several databases through 8 March 2016 for studies evaluating genital reconstructive surgery in females with CAH. Reviewers working independently and in duplicate selected and appraised the studies.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>We included 29 observational studies (1178 patients, mean age at surgery, 2.7 \u00b1 4.7 years; mostly classic CAH). After an average follow-up of 10.3 years, most patients who had undergone surgery had a female gender identity (88.7%) and were heterosexual (76.2%). Females who underwent surgery reported a sexual function score of 25.13 using the Female Sexual Function Index (maximum score, 36). Many patients continued to complain of substantial impairment of sensitivity in the clitoris, vaginal penetration difficulties, and low intercourse frequency. Most patients were sexually active, although only 48% reported comfortable intercourse. Most patients (79.4%) and treating health care professionals (71.8%) were satisfied with the surgical outcomes. Vaginal stenosis was common (27%), and other surgical complications, such as fistulas, urinary incontinence, and urinary tract infections, were less common. Data on quality of life were sparse and inconclusive.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>The long-term follow-up of females with CAH who had undergone urogenital reconstructive surgery shows variable sexual function. Most patients were sexually active and satisfied with the surgical outcomes; however, some patients still complained of impairment in sexual experience and satisfaction. The certainty in the available evidence is very low.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1210\/jc.2018-01863","type":"journal-article","created":{"date-parts":[[2018,9,29]],"date-time":"2018-09-29T00:49:44Z","timestamp":1538182184000},"page":"4089-4096","source":"Crossref","is-referenced-by-count":96,"title":["Genital Reconstructive Surgery in Females With Congenital Adrenal Hyperplasia: A Systematic Review and Meta-Analysis"],"prefix":"10.1210","volume":"103","author":[{"given":"Jehad","family":"Almasri","sequence":"first","affiliation":[{"name":"Evidence-Based Practice Research Program, Mayo Clinic, Rochester, Minnesota"},{"name":"Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feras","family":"Zaiem","sequence":"additional","affiliation":[{"name":"Department of Pathology, Karmanos Cancer Institute, Wayne State University School of Medicine, Detroit, Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rene","family":"Rodriguez-Gutierrez","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Department of Internal Medicine, University Hospital Dr. Jose E. Gonzalez, Autonomous University of Nuevo Leon, Monterrey, Mexico"},{"name":"Plataforma INVEST Medicina UANL-KER Unit Mayo Clinic, Autonomous University of Nuevo Leon, Monterrey, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shrikant U","family":"Tamhane","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Mayo Clinic, Rochester, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anoop Mohamed","family":"Iqbal","sequence":"additional","affiliation":[{"name":"Division of Pediatrics and Adolescent Medicine, Department of Pediatric Endocrinology, Mayo Clinic, Rochester, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Larry J","family":"Prokop","sequence":"additional","affiliation":[{"name":"Mayo Clinic Libraries, Mayo Clinic, Rochester, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Phyllis W","family":"Speiser","sequence":"additional","affiliation":[{"name":"Division of Pediatric Endocrinology, Cohen Children\u2019s Medical Center and Zucker Hofstra Northwell School of Medicine, Lake Success, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurence S","family":"Baskin","sequence":"additional","affiliation":[{"name":"Department of Urology, University of California, San Francisco, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irina","family":"Bancos","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Mayo Clinic, Rochester, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5502-5975","authenticated-orcid":false,"given":"M Hassan","family":"Murad","sequence":"additional","affiliation":[{"name":"Evidence-Based Practice Research Program, Mayo Clinic, Rochester, Minnesota"},{"name":"Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"80","published-online":{"date-parts":[[2018,9,28]]},"reference":[{"issue":"2-3","key":"2020071621583841600_B1","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1016\/0925-6164(93)90024-D","article-title":"Congenital adrenal hyperplasia due to 21-hydroxylase deficiency: newborn screening and its relationship to the diagnosis and treatment of the disorder","volume":"2","author":"Pang","year":"1993","journal-title":"Screening"},{"issue":"9477","key":"2020071621583841600_B2","doi-asserted-by":"crossref","first-page":"2125","DOI":"10.1016\/S0140-6736(05)66736-0","article-title":"Congenital adrenal hyperplasia","volume":"365","author":"Merke","year":"2005","journal-title":"Lancet"},{"issue":"9","key":"2020071621583841600_B3","doi-asserted-by":"crossref","first-page":"4133","DOI":"10.1210\/jc.2009-2631","article-title":"Congenital adrenal hyperplasia due to steroid 21-hydroxylase deficiency: an Endocrine Society clinical practice guideline","volume":"95","author":"Speiser","year":"2010","journal-title":"J Clin Endocrinol Metab"},{"issue":"4","key":"2020071621583841600_B4","doi-asserted-by":"crossref","first-page":"943","DOI":"10.1007\/s10508-017-1003-8","article-title":"Stigma associated with classical congenital adrenal hyperplasia in women\u2019s sexual lives","volume":"47","author":"Meyer-Bahlburg","year":"2018","journal-title":"Arch Sex Behav"},{"issue":"10","key":"2020071621583841600_B5","doi-asserted-by":"crossref","first-page":"1006","DOI":"10.1016\/j.jclinepi.2009.06.005","article-title":"Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement","volume":"62","author":"Moher","year":"2009","journal-title":"J Clin Epidemiol"},{"key":"2020071621583841600_B6","unstructured":"Almasri\n              J\n            , ZaiemF, Rodriguez-GutierrezR, TamhaneS, IqbalA, ProkopL, SpeiserP, BaskinL, BancosI, Murad MH. 2018 Supplemental material. figshare 2018. 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