(016) Laparoscopic Bilateral Gonadectomy in Complete Androgen Insensitivity Syndrome: Surgical Approach and Multidisciplinary Management

Introduction Complete androgen insensitivity syndrome (CAIS) is a rare disorder of sex development in which individuals have a 46,XY karyotype but develop a female phenotype because of complete resistance to androgens. These patients often present with primary amenorrhea. Gonadectomy is usually recommended to prevent malignancy. We report a case of CAIS treated by laparoscopic bilateral gonadectomy, focusing on surgical technique and multidisciplinary management. Objective To present a case of CAIS managed by laparoscopic gonadectomy and to share our experience in surgical approach and postoperative care. Methods A 27-year-old female patient presented with primary amenorrhea. Physical examination showed normal female phenotype with sparse pubic hair. Hormonal analysis revealed high LH and testosterone in the male range, while FSH was within normal limits. Karyotype was 46,XY. MRI demonstrated bilateral intra-abdominal gonads near the internal inguinal rings and absence of uterus and ovaries. After multidisciplinary discussion involving urologists, endocrinologists, and psychologists, laparoscopic bilateral gonadectomy was performed using a five-port transperitoneal approach. The gonads were removed completely and sent for histopathological examination. Results The operation was completed safely with minimal blood loss and no complications. Both gonads were small and firm. Histopathology showed atrophic seminiferous tubules and fibrosis without evidence of malignancy. The patient recovered well and was discharged the next day. Hormone replacement therapy with transdermal estradiol was started. At three-month follow-up, she was doing well physically and psychologically. Conclusions Laparoscopic gonadectomy is a safe and effective procedure for patients with CAIS. The minimally invasive approach provides good visualization and cosmetic results. Multidisciplinary cooperation plays an important role in diagnosis, surgery, hormonal therapy, and long-term follow-up. This case demonstrates the importance of teamwork to achieve optimal outcomes for patients with disorders of sex development. Disclosure No