logo
PAEDIATRIC UROLOGY

10.4.2 Indications for the removal of gonads

The gonads of intersex patients should be removed in the following cases:

  1. Inappropriate gonadal type for the sex of rearing, as in male pseudohermaphrodites who are to be reared as girls or true hermaphrodites where discordant gonadal tissue is not needed. This type of surgery should be performed as early as possible in the neonate.

  2. High risk of malignancy (gonadoblastoma/dysgerminoma). Particularly for patients with mixed gonadal dysgenesis and those with true gonadal dysgenesis and 46XY karyotype. To a lesser extent, for male pseudohermaphrodites with androgen receptor insensitivity and true hermaphrodites with 46XY karyotype. The risk for gonadal tumour is real after puberty, hence this type of surgery can be postponed until that age.