[SS-009]
Oturum adı: ORAL SESSION 1 | Oturum salonu: SALON 4 | Oturum tarihi: 23 Ekim 2015 | Oturum saati: 13:30 - 15:00Laparoscopic Approach for Persistent Mullerian Duct Syndrome
Ali Gürağaç1, Zafer Demirer2, Bahadır Topuz1, Bilal Fırat Alp1, Hasan Cem Irkılata1, İbrahim Yıldırım12Department of Urology, Eskişehir Military Hospital, Eskisehir, Turkey
Introduction and OBJECTIVES: Persistent mullerian ductus syndrome (PMDS) is a rare form of internal male sexual development disorder. This pathological condition usually realized at prepubertal and pubertal ages of life. We present laparoscopic removal of mullerian structures and laparoscopy-asisted bilateral orchiopecy in adult man with PMDS.
METHODS: A 20 year old male patient presented for evaluation of bilateral undescended testes. Physical examination revealed a healty man with fully-developed secondary sex characteristics and normal-sized penis but testes were not palpable in the scrotum and inguinal region. Hormonal evaluation demostrated normogonadotropic normogonadism. Karyotype was 46, XY. Ultrasonographic evaluation showed a 30x29 mm structure that may be related with undescended testis at adjacent to right internal iliac vein. Diagnostic laparoscopy performed. Bilateral testes were seen intraabdominal region and connected with uterus and fallopian like structures. Uterus and fallopian tube like structures were separated from testes and prostate. Bilateral testes dissected from peritoneum laparoscopically and placed to the scrotum.
RESULTS: Operating time was approximatelly 160 minutes with estimated blood loss of 150 ml. Histopathological examination of the specimen was compatible with PMDS. The patient discharged 4 days after surgery. The convalescence was uneventful. Color doppler ultrasonograhy demonstrated good blood supply in the bilateral testes at second and fourth months of the surgery. The testes size were as same as at operation time.
CONCLUSION: The laparoscopic removal of mullerian structures and bilateral orchipoexy in patients with PMDS, who have bilateral undescended testes, is a minimal invasive and valid treatment choice to the traditional surgery.
Figure 1
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Bilateral undescended testes were delivered via deep inguinal rings under laparoscopic guidence, adjacent mullerian structures incised, bilateral inguinal rings were enlarged, bilateral testes delivered via deep inguinal ring, mullerian structures withdrawn