Disorders of Sexual Development in Resource-Limited Settings

Yarhere, Iroro; Ahmed, S Faisal

doi:10.1016/b978-0-12-407822-2.00005-0

Cited by 1 publication

(1 citation statement)

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“…It was also noteworthy that there were variations in practice between LMIC and HIC centres with the proportion of cases that had a gonadectomy being lower in LMIC countries. The older age at gonadectomy at the LMIC centres may be secondary to an older age at presentation in these cases but the lower proportion of cases undergoing gonadectomy may be due to difficulties in access to specialist diagnostic or surgical services (19,24) or due to differences in cultural and societal attitudes to gonadectomy (25). These aspects as well as the surveillance measures that are used for monitoring retained gonads will need to be explored in future studies.…”

Section: Discussionmentioning

confidence: 99%

Gonadectomy in conditions affecting sex development: a registry-based cohort study

Lucas‐Herald

Bryce

Kyriakou

et al. 2021

European Journal of Endocrinology

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Objectives: To determine trends in clinical practice for individuals with DSD requiring gonadectomy. Design: Retrospective cohort study. Methods: Information regarding age at gonadectomy according to diagnosis; reported sex; time of presentation to specialist center; and location of center from cases reported to the International DSD Registry and who were over 16 years old in January 2019. Results: Data regarding gonadectomy were available in 668 (88%) individuals from 44 centers. Of these, 248 (37%) (median age (range) 24 (17, 75) years) were male and 420 (63%) (median age (range) 26 (16, 86) years) were female. Gonadectomy was reported from 36 centers in 351/668 cases (53%). Females were more likely to undergo gonadectomy (n=311, p<0.0001). The indication for gonadectomy was reported in 268 (76%). The most common indication was mitigation of tumour risk in 172 (64%). Variations in the practice of gonadectomy were observed; of the 351 cases from 36 centers, 17 (5%) at 9 centers had undergone gonadectomy before their first presentation to the specialist center. Median age at gonadectomy of cases from high income countries and low/middle income countries (LMIC) was 13.0 yrs (0.1, 68) years and 16.5 yrs (1, 28), respectively (p<0.0001) with the likelihood of long-term retention of gonads being higher in LMIC countries. Conclusions: The likelihood of gonadectomy depends on the underlying diagnosis, sex of rearing and the geographical setting. Clinical benchmarks, which can be studied across all forms of DSD will allow a better understanding of the variation in the practice of gonadectomy.

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Section: Discussionmentioning

confidence: 99%