Experience of Laparoscopic Exploration and Gonadectomy in lntersex Children

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.