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Gonadectomy in conditions affecting sex development: a registry-based cohort study
Angela K Lucas-Herald1, Jillian Bryce1, Andreas Kyriakou1
1Developmental Endocrinology Research Group, University of Glasgow, Glasgow, UK.
European Journal of Endocrinology
|March 29, 2021
Summary
Gonadectomy trends in disorders/differences/differences of sex development (DSD) show females are more likely to undergo the procedure, often to mitigate tumor risk. Practice variations exist, with lower gonadectomy rates in low- and middle-income countries.
Area of Science:
- Endocrinology
- Pediatric Surgery
- Genetics
Background:
- Disorders/differences of sex development (DSD) encompass a range of conditions affecting sexual development.
- Gonadectomy is a surgical procedure to remove the gonads, often considered in DSD management.
- Clinical practice patterns for gonadectomy in DSD populations require clarification.
Purpose of the Study:
- To investigate current clinical practices and trends in gonadectomy for individuals with DSD.
- To identify factors influencing the decision to perform gonadectomy, including diagnosis, sex of rearing, and geographical location.
Main Methods:
- Retrospective cohort study utilizing data from the International DSD Registry.
- Analysis of cases involving individuals over 16 years old in January 2019.
- Data extraction focused on age at gonadectomy, diagnosis, sex, and center characteristics.
Main Results:
- Data from 668 individuals across 44 centers were analyzed; 53% underwent gonadectomy.
- Females were significantly more likely to undergo gonadectomy (311 cases) compared to males (248 cases).
- Tumor risk mitigation was the most common indication (64%); practice variations were observed, with higher gonadectomy rates in high-income countries.
Conclusions:
- Gonadectomy likelihood in DSD is influenced by diagnosis, sex of rearing, and geographic setting.
- Significant variations in gonadectomy practices necessitate the development of clinical benchmarks for all DSD forms.
- Further research is needed to understand and standardize gonadectomy management in DSD.
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