Early versus late intervention of congenital adrenal hyperplasia.

At the annual NASPAG meeting in San Diego, there was much discussion about the appropriate timing for treating young girls with congenital adrenal hyperplasia. Traditionally a reduction clitoroplasty and cutback vulvoplasty are often performed in the neonatal period. When surgery is performed in the neonatal period, a second surgery is often required at the time of puberty to improve vaginal caliber. More recently, however, some experts are suggesting delaying corrective surgery until adolescence to possibly improve the surgical results. This allows the patient to participate in the decision for surgery. Females who are deficient in 21-hydroxlase will experience clitoral hypertrophy, labioscrotal fusion, and