Skip to main content
Log in

Exclusion of androgen insensitivity syndrome in girls with inguinal hernias: current surgical practice

  • Original Article
  • Published:
Pediatric Surgery International Aims and scope Submit manuscript

Abstract.

To review the current approach of paediatric surgeons to the exclusion of androgen insensitivity syndrome (CAIS) in girls with inguinal hernias (IH), a questionnaire was sent to all specialist paediatric surgeons in the United Kingdom and Ireland asking if they exclude CAIS, how they exclude it, and what they say to parents preoperatively. In all, 32 surgeons responded (29%); 41% made no attempt to exclude CAIS because they thought the incidence was too low to justify exclusion; 19(59%) excluded CAIS at the time of surgery by assessment of the internal genitalia. Only 1 performed karyotyping primarily, and then only for bilateral IH. Although most would proceed to karyotyping if the primary assessment suggested CAIS, some would not. Of those who exclude CAIS, only 1 mentions CAIS preoperatively, 6 others mention gonadal inspection, and 12/19 (63%) make no comment. Thirty-one surgeons agreed to take part in a prospective study to define the incidence of CAIS in girls with IH. It is concluded that surgeons who exclude CAIS in girls with IH adopt different assessment methods, some of which may be unreliable. However, many do not attempt to exclude CAIS, believing the incidence to be too low. As the health and medicolegal consequences of failing to exclude CAIS may be considerable, surgeons should consider changing their practice. A prospective study should be undertaken to determine the incidence of CAIS in girls with IH.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Carmichael R, Oldfield C (1934) A case of complete male pseudohermaphroditism with intra-abdominal teratoma testis. J Pathol Bacteriol 39: 617–622

    Google Scholar 

  2. Dodge ST, Finkleston MS, Miyasawa K (1985) Testicular feminization with incomplete Mullerian regression. Fertil Steril 43: 937

    CAS  PubMed  Google Scholar 

  3. Gans SL, Rubin CL (1962) Apparent female infants with hernias and testes. Am J Dis Child 104: 82

    CAS  Google Scholar 

  4. German J, Simpson JL, Morillo-Cucci G, Passarge E, De May AP (1973) Testicular feminisation and inguinal hernia. Lancet i: 891

    Google Scholar 

  5. Goldstein IR, Potts WJ (1958) Inguinal hernia in female infants and children. Ann Surg 148: 819

    CAS  Google Scholar 

  6. Hurt WG, Bidurtha JN, McCall JB, Moinuddin Azi M (1989) Seminoma in prepubertal patients with androgen insenstivity syndrome. Am J Obstet Gynecol 161: 530–531

    CAS  PubMed  Google Scholar 

  7. Jagiello G, Atwell JD (1962) Prevalence of testicular feminisation. Lancet i: 329

    Google Scholar 

  8. Kaplan SA (1969) Inguinal hernias in females and the testicular feminisation syndrome. Am J Dis Child 117: 243

    Google Scholar 

  9. Morris JM (1953) The syndrome of testicular feminisation in male pseudohermaphrodites. J Obstet Gynecol 65: 1192–1211

    Google Scholar 

  10. Oka M, Katabuchi H, Munemura M, Mizumoto J, Maeyama M (1984) An unusual case of male pseudohermaphroditism: complete testicular feminization associated with incomplete differentiation of the Mullerian duct. Fertil Steril 41: 154

    CAS  PubMed  Google Scholar 

  11. Rutgers JL, Scully RE (1991) The androgen insensitivity syndrome (testicular feminization): a clinicopathologic study of 43 cases. Int J Gynecol Pathol 10: 126–144

    CAS  PubMed  Google Scholar 

  12. Viner RM, Teoh Y, Williams DM, Patterson MN, Hughes IA (1997) Androgen insensitivity syndrome: a survey of diagnostic procudures and management in the UK. Arch Dis Child 77: 305–309

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Burge, D.M., Sugarman, I.S. Exclusion of androgen insensitivity syndrome in girls with inguinal hernias: current surgical practice. Ped Surgery Int 18, 701–703 (2002). https://doi.org/10.1007/s00383-002-0801-8

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00383-002-0801-8

Keywords.

Navigation