Bilateral orchiectomy for the surgical treatment of complete androgen insensitivity syndrome: patient outcome after 1 year of follow-up.
OBJECTIVE
To describe an operative approach to bilateral orchiectomy for complete androgen insensitivity syndrome (AIS) and to report patient status 1 year after surgery.


METHODS
A 19(1/2)-year-old woman with primary amenorrhea, cervical/uterine agenesis, elevated serum testosterone, and 46,XY karyotype underwent characterization of the androgen receptor mutation by polymorphism sequence analysis. Bilateral orchiectomy was performed via a triple-puncture 5-mm laparoscope, and postsurgical hormone replacement followed a daily oral contraceptive model. Psychological counseling was provided to the patient and her family.


RESULTS
Minimally invasive removal of the gonads was accomplished without complication. Microscopic examination of the testes revealed a benign Sertoli cell-only pattern. After 1 year, the patient's level of functioning and psychosexual status were unchanged in comparison with before surgery.


CONCLUSIONS
Patients with complete AIS should undergo postpubertal gonadectomy because of an increased risk for malignant transformation of the testicles, and this can be performed safely via small-caliber laparoscopy. Attention to psychological considerations in such patients is important to maximize long-term success.
Sills
E Scott
ES
Reproductive Specialists LLC, Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Atlanta Medical Center, Atlanta, Georgia 30342, USA. dr.sills@ivf.com
Perloe
Mark
M
Kaplan
Carolyn R
CR
Schlegel
Peter N
PN
Palermo
Gianpiero D
GD
D013734:Androgen-Insensitivity Syndrome / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009919:Orchiectomy / Q000379:methods; D016896:Treatment Outcome