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Bilateral laparoscopic gonadectomy in a patient with complete androgen insensitivity. A case report
C W Obianwu1, S F Palter, A A Bruno
1Department of Obstetrics and Gynecology, Hahnemann University, Philadelphia, Pennsylvania, USA.
Background:
Complete androgen insensitivity (CAI) is the most common cause of male pseudohermaphroditism. Affected individuals are advised to have bilateral gonadectomies to prevent the development of germ cell tumors.
Case:
A 19-year-old phenotypic female presented for the evaluation of primary amenorrhea and was diagnosed with CAI. Operative videolaparoscopy was performed, and the intraabdominal gonads were resected; the patient was discharged in < 24 hours.
Conclusion:
Laparoscopic gonadectomy can be performed in individuals with CAI. This approach eliminates the need for laparotomy and results in rapid recovery with minimal blood loss. This approach should be considered for all patients with CAI and intraabdominal gonads.
Insights
Laparoscopic gonadectomy is a safe and effective procedure for individuals with complete androgen insensitivity (CAI), offering rapid recovery. This minimally invasive approach avoids laparotomy, making it ideal for preventing germ cell tumors in CAI patients.
Area of Science:
- Reproductive Endocrinology
- Minimally Invasive Surgery
- Genetics
Background:
- Complete androgen insensitivity (CAI) is the most common cause of male pseudohermaphroditism.
- Individuals with CAI are at increased risk for germ cell tumors, necessitating gonadectomy.
- Standard surgical management often involves laparotomy.
Observation:
- A 19-year-old phenotypic female with primary amenorrhea was diagnosed with CAI.
- Laparoscopic surgery was utilized for intraabdominal gonad resection.
- The patient experienced a rapid recovery, with discharge in under 24 hours.
Findings:
- Laparoscopic gonadectomy is a feasible surgical option for CAI patients.
- The procedure resulted in minimal blood loss and a short recovery period.
- This technique effectively addresses the need for gonad removal in CAI.
Implications:
- Laparoscopic gonadectomy offers a less invasive alternative to laparotomy for CAI.
- This approach facilitates quicker patient recovery and reduces surgical morbidity.
- Consideration of laparoscopic gonadectomy is recommended for all CAI patients with intraabdominal gonads.