Female inguinal hernias and testicular feminization

Surgeons and clinicians should be aware of testicular feminization and its implications in performing inguinal hernia repairs on female patients of any age. Removal of the gonads is probably indicated only after pubertal growth is complete. Other intersex conditions usually require prepubertal gonadectomy, but in these patients diagnosis is often made before any planned hernia repair. Incisional biopsy of abnormal gonads is important, but the diagnosis of testicular feminization must be confirmed by appropriate laboratory tests. Corticosteroids should be given to cover the immediate postoperative period so that patients with biochemical defects will not have hypoadrenalism.