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Laparoscopic gonadectomy in male pseudohermaphrodites
A Kriplani1, M Abbi, A C Ammini
1Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi. kriplani@medinst.ernet.in
Objective:
To study patients of male pseudohermaphroditism and establish the laparoscopic approach for gonadectomy in these cases.
Study Design:
Seven phenotypic females with XY karyotype were evaluated through a diagnostic protocol which included clinical, cytogenetic, hormonal, endoscopic and histologic evaluation. The gonads were then removed by laparoscopic surgery.
Results:
The seven patients included three patients of pure gonadal dysgenesis, two patients of testicular feminization and one patient each of mixed gonadal dysgenesis and dysgenetic male pseudohermaphroditism. Two of the seven patients (28.57%) had gonadal neoplasias on histopathology-one dysgerminoma and one occult seminoma. In all of these patients, removal of the gonads was accomplished laparoscopically. No complications occurred during any of the surgeries.
Conclusion:
Due to the reduced morbidity, shorter hospital stay and safety, laparoscopic gonadectomy can be considered the treatment of choice for the removal of gonads in male pseudohermaphrodites in the hands of experienced laparoscopic surgeons.