Laparoscopy in intersex patients raised as females

Abstract

The newborn with ambiguous genitalia needs a multidisciplinary approach for sex assignment. Gonadal histology is required in some patients with abnormal gonadal development, such as mixed gonadal dysgenesis, true hermaphroditism, and testicular dysgenesis patients. Laparoscopy has been found to be helpful in these conditions where gonads may be inconsistent with the sex of rearing or premalignant (Docimo and Peters 2002). Although sex may be assigned before the biopsy is taken, histology in these patients is necessary for definitive diagnosis. Under such conditions biopsy and eventual gonadal resection may be done at the same time as feminizing genitoplasty. Only in a few patients, mostly true hermaphrodites, is definitive histology required for sex assignment. Another related indication is complete testicular insensitivity. In such XY females the gonads can be removed laparoscopically (Yu et al. 1995). The role of laparoscopy in the intersex condition to be raised as males such as excision of müllerian structures, prostatic utricle, and orchidopexy is addressed in other chapters (Chapters 99, 101). © Springer-Verlag Berlin Heidelberg 2008.