Inguinal Hernias in Females and the Testicular Feminization Syndrome

Abstract

The purpose of this seminar is to discuss a problem which has aroused considerably difference of opinion among the staff members of this hospital. The problem is: Should every female with inguinal hernias be studied to determine if she has the testicular feminization syndrome? Recently, I received a complaint from a member of the staff about such a patient. The patient had undergone surgery and, on the day of discharge, the intern made a buccal smear for sex chromatin determination in the presence of the parents. When the parents asked about the purpose of the test, they learned that it was to find out if the gonads were normal. This question had not been raised previously and the parents were quite upset about the possibility of such an abnormality. Moreover they were distressed to learn about the possibility of a gonadal disorder in this way. They had been informed by their pediatrician and surgeon that surgical correction of inguinal hernias was a simple routine pro¬ cedure and were unaware that anything

Male Pseudohermaphroditism: Etiological Evaluation, Surgical Treatment, and the Incidencein Relation to Inguinal Hernia

“…Kaplan et al estimated this incidence to be 1.4%. 12 This was our finding as well. The frequency rose to 6.3% in females with bilateral inguinal hernias and 12.5% in females with bilateral synchronous inguinal hernias.…”

Mujer con seminoma puro y neoplasia intratubular germinal contralateral. Informe de un caso

“…El tratamiento es con orquiectomía bilateral y terapia de reemplazo hormonal posterior, ya que a mayor edad se asocia un mayor riesgo de malignidad testicular 12 . El apoyo psicológico y asesoramiento también son esenciales, tanto para los pacientes como para sus familias.…”

The incidence of complete androgen insensitivity in girls with inguinal hernias and assessment of screening by vaginal length measurement

“…Prompt diagnosis also allows for education about the risk of gonadal malignancy. Although most cases of testicular cancer in patients with CAIS do not occur until after puberty, early malignant transformation has been documented [9,11]. Some advocate leaving the gonads in situ through puberty because testosterone is converted to estrogen and aids in secondary sexual development [13].…”

“…Because of this association, it has been suggested that all premenstrual girls with inguinal hernias should be examined for CAIS [8,9]. Unless specific steps are taken, surgeons can repair inguinal hernias and not recognize the underlying condition, missing the opportunity for early diagnosis.…”