Laparoscopic gonadectomy of streak gonads within the inguinal canals in a patient with XY partial gonadal dysgenesis.

Song, Mi Hyun; Ahn, Byul Nim; Kim, Hae Kyung; Oh, Hoon Kyu; Lee, Tae Sung; Choi, Youn Seok

doi:2012.55.3.209

Case Report

Korean Journal of Obstetrics & Gynecology 2012;55(3):209-212.
DOI: https://doi.org/10.5468/KJOG.2012.55.3.209 Published online March 1, 2012.

Laparoscopic gonadectomy of streak gonads within the inguinal canals in a patient with XY partial gonadal dysgenesis.

Mi Hyun Song, Byul Nim Ahn, Hae Kyung Kim, Hoon Kyu Oh, Tae Sung Lee, Youn Seok Choi

¹Department of Obstetrics and Gynecology, The Catholic University of Daegu School of Medicine, Daegu, Korea. drcys@cu.ac.kr
²Department of Pathology, The Catholic University of Daegu School of Medicine, Daegu, Korea.

Abstract

A 33-year-old phenotypic female presented with primary amenorrhea. The physical examination revealed no breast development, scanty axillary and pubic hair, normal female external genitalia, and a short blind vagina. The findings of magnetic resonance imaging, karyotyping, and hormonal examinations supported the diagnosis of XY partial gonadal dysgenesis. Laparoscopic surgery showed that spermatic cords, including the bilateral streak gonads and epididymes, were within the inguinal canals. After opening the spermatic cords and identifying the lower borders of the streak gonads, the spermatic cords were transected at the level of the vas deferens. A prophylactic herniorrhaphy using polyprophylene mesh was performed due to weakening of the internal inguinal ring. Pathologic evaluation of the gonads confirmed the diagnosis of partial gonadal dysgenesis without evidence of malignancy. A laparoscopic approach is feasible for treatment of XY gonadal dysgenesis, even if the streak gonads are present within the inguinal canal.

Key Words: Laparoscopy, Gonadectomy, Gonadal dysgenesis, Inguinal canal, Streak gonad