Laparoscopic surgery in 46,XX disorder of sex development: hysterosalpingectomy with gonadectomy.
OBJECTIVE
We present the outcomes of one of the largest series specifically of laparoscopic hysterosalpingectomy with bilateral gonadectomy in 46,XX patients with congenital adrenal hyperplasia raised as a male.


METHODS
From June 2005 to March 2008, five patients raised as male were treated at our institution using laparoscopic surgery. 46,XX disorder of sex development was diagnosed in all the patients because of congenital adrenal hyperplasia. Hysterosalpingectomy with bilateral gonadectomy was performed completely laparoscopically in all five patients.


RESULTS
All procedures were completed with minimal blood loss. The duration of the surgeries was 70-125 minutes. There were no complications during surgery or conversion to open surgery. The hospital stay ranged from 1 to 2 days, except in one patient who presented urinary retention and was discharged from the hospital a week after the surgery.


CONCLUSIONS
Laparoscopic surgery can be safely used as part of the diagnosis and treatment of 46,XX disorder of sex development. Laparoscopy can be useful in the diagnosis as well as surgical management of Müllerian structures as well as intraabdominal gonads contrary to social sex.
de Lima
George Rafael Martins
GR
Department of Urology, Federal University of Ceará, Fortaleza, Brazil. rafael.urologia@yahoo.com.br
de Cerqueira
João Batista Gadelha
JB
da Silveira
Rômulo Augusto
RA
de Moura Reis
Paulo Henrique
PH
Rocha
Marcos Flávio Holanda
MF
Regadas
Rommel Prata
RP
Leitão
Alexandre Sabóia
AS
Gonzaga-Silva
Lúcio Flávio
LF
D000293:Adolescent; D005187:Fallopian Tubes / Q000601:surgery*; D005260:Female; D023961:Gonadal Dysgenesis, 46,XX / Q000150:complications / Q000601:surgery*; D006066:Gonads / Q000601:surgery*; D006801:Humans; D007044:Hysterectomy; D010535:Laparoscopy; D008297:Male; D014770:Virilism / Q000150:complications / Q000601:surgery