Use of Laparoscopy in Intersex Patients

“…Just genetic gonads which may have a malignant after the laparoscopic evaluation, ablative treatpotential in the future [2,3]. The use of laparoment can be simultaneously performed such as scopic technique in intersex children is not anecgonadectomy, herniorrhaphy and hysterosalpindotal any more, but now widespread for the gectomy along with the diagnosis and gender evaluation and management of these children identity [6]. Advantage of laparoscopic procedure [4,5].…”

Section: Discussionmentioning

confidence: 99%

Experience of Laparoscopic Exploration and Gonadectomy in lntersex Children

Morita

Nonomura

Ameda

et al. 1997

Diagnostic and Therapeutic Endoscopy

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The use of laparoscopic technique to diagnose and treat intersex children is gradually introduced in clinical urology. From 1985 to 1996, abdominal exploration and gonadectomy were performed in 11 intersex children together with urogenital endoscopy and genitoplastic surgery in our institutes. Their median age was 6.0 (range 0-15) years old and initial gender sex was female in 8 and male in 3. The initial 4 cases (group 1) underwent open abdominal exploration together with gonadectomy, while the latter 7 cases (group 2) underwent laparoscopic exploration simultaneously with 3 laparoscopic gonadectomy and 1 open one via a inguinal incision. Their final diagnoses were male pseudohermaphroditism in 4 cases, mixed gonadal dysgenesis in 3, true hermaphroditism in 2, XX gonadal dysgenesis in 1, and XY gonadal dysgenesis in 1. Consequently, 2 of initial male were reared as a female. Operation time, use of analgesics, postoperative hospital stay and postoperative complications were not significantly different between the two groups, however, postoperative abdominal wound appearance was more acceptable in group 2. The most significant advantage of laparoscopic surgery in intersex children is cosmetic appearance especially when social gender is determined as female irrespective types of intersexuality.

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“…Once identified, the gonads are resected, most often together with the ductal structures. In the presence of a normal testis in a patient with a male social sex, laparoscopic orchidopexy can be performed [2].…”

Section: Methodsmentioning

confidence: 99%

“…objective is to offer the best quality of life, reconciling structural limitations with the functional potential of the external genital organs, and adjusting them to the psychological characteristics and gender preferences of the patient, whenever defined [1,2].…”

Section: Introductionmentioning

confidence: 99%

The laparoscopic management of intersex patients: the preferred approach

et al. 2005

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In the world's largest series of patients with intersex treated by laparoscopy, authors from Sao Paulo found that this technique allowed easy identification and removal of gonads. They also found that other organs could be removed and genitoplasty performed. OBJECTIVE To present possibly the largest series of the use of laparoscopy for treating intersex patients. PATIENTS AND METHODS Fifty intersex patients (34 with male and two with female pseudohermaphroditism, nine with gonadal dysgenesis, four with true hermaphroditism, and one with complex hypospadias), aged 0.5–46 years (mean 18.3), underwent laparoscopy to remove gonads and/or ductal structures incompatible with the social gender, or for gonadal tumour or a potential risk for malignancy. When necessary, genitoplasty was performed concomitantly. RESULTS At the laparoscopic evaluation, 10 gonads of six patients were absent, while four were identified as ‘vanishing’; 72 gonads (46 dysgenetic, 17 normal testes, one normal ovary, one ovotestis, seven gonadoblastomas or dysgerminomas) were removed; two ovotestes were replaced in the scrotum after removing the ovarian segment, as was one normal testis. Twelve patients with a urogenital sinus had its vaginal component removed, 11 including a hysterectomy. Three of these patients had a combined perineal approach to complete its removal, together with masculinizing genitoplasty. There were no intraoperative complications or conversions; two patients had complications after surgery. CONCLUSIONS Laparoscopy allows the straightforward identification and removal of gonads. All abnormal ductal structures must be removed, as this increases the chance of resecting unidentified gonads. Removing the uterus and vaginal component of the urogenital sinus in patients with male social sex is feasible, with low morbidity. Genitoplasty, according to the social sex, can be performed in the same procedure.

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Use of Laparoscopy in Intersex Patients

Cited by 36 publications

References 20 publications

The Use of Laparoscopy in the Management of Adnexal Pathologies in Children

The Use of Laparoscopy in the Management of Adnexal Pathologies in Children

Experience of Laparoscopic Exploration and Gonadectomy in lntersex Children

The laparoscopic management of intersex patients: the preferred approach

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