Laparoscopic Gonadectomy in Testicular Feminization

Document Type : Case report

Authors

1 Professor of Urology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

2 Assistant Professor of Obstetrics & Gynecology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

3 Associate Professor of Obstetrics & Gynecology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

4 Professor of Pathology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

5 Urologist, Mashhad, Iran

6 Ph.D. of Physiology, Mashhad, Iran

Abstract

Introduction: Testicular feminization is a rare X linked syndrome with 46 XY karyotype. The aim of this report was to present the role of laparoscopy in the diagnosis and treatment of this syndrome.
 
Materials & Patients: Two women referred to us with a history of amenorrhea. They were 23 and 19 years olds. Physical examination showed normal pubic hair and normal development of external genitalia and breasts. Ultrasonography of abdomen showed; agenesis of the uterus and existence of two gonads near the internal inguinal rings. Hormonal assays were done and karyotype study showed 46XY. In order to confirm the diagnosis by laparoscopy, under general anesthesia and by using Hasson technique, a 10Fr trocar was inserted and totally the four
 
Results: Testes were seen in the abdomen of two patients. Because of the risk of gonadoblastoma, two 5F trocars were introduced in midclavicular lines (below the umbilicus), the gonads were released from the surrounding tissues, and after ligating the vascular attachments the gonads were excised and removed through the trocar incision sites. Post laparoscopy course was uneventful and both patients discharged home after two days. Histopathologic study of the removed gonads confirmed testicular features.
 
Conclusion: Having considered the minimal morbidity and complications in this two cases and report the experience of other authors, it seems that, laparoscopic gonadectomy might be a suitable option in managing patients with testicular feminization.

Keywords

References

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The Iranian Journal of Obstetrics, Gynecology and Infertility
Volume 11, Issue 4 - Serial Number 4
December 2009
Pages 62-66

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