Introduction:  Congenital adrenal hyperplasia (CAH) in patients with karyotype 46 XX is the first cause of genital virilization. The feminizing genitoplasty is performed in these children with the aim to restore the female aspect of genitalia while preserving dorsal neurovascular bundles and drying erectile tissue. There is no gold standard technique, but 1-step genitoplasty including clitoroplasty has shown excellent results. 

Material and methods: Twelve patients with genital virilization caused by CAH with initial prader classification 2- 5  were submitted in one step  feminizing genitoplasty in the period of June 2021 to July 2022. A Clavien-Dindo scale was applied in order to assess the outcomes and postoperative complications of the procedure. . Six of them had already undergone the procedure for more than six months and could be submitted to evaluations through questionnaires (about aesthetics and functionality of the urinary tract) and sensitivity tests (through nylon monofilaments).

Results: The patients presented excellent aesthetic and sensitivity results. The mean age of the operated patients was 66 months.  Complications were assessed using the Clavien-Dindo Scale, which identified Grade I (edema and hematoma with spontaneous resolution) in only 33.3% of participants and Grade IIIb (granuloma in the suture lines, or dehiscence labia majora, that required a surgical procedure under anesthesia for correction) in 16.6% of the participants. The surgical time of the procedures did not exceed 4 hours. Only one patient required reintervention due to discomfort and persistence of clitoromegaly. There was no need for blood transfusion, soft tissue infection, tissue loss, ischemia, necrosis and loss of sensitivity of the clitoris.

Conclusion: Feminizing genitoplasty is a safe surgery with few postoperative complications. The Claven-Dindo Classification was primarily Grade I with none or mild complications. In addition, the aesthetic and sensitivity results proved to be satisfactory, encouraging its improvement.