ESPE Abstracts

Objective: To determine the clinical characteristics of patients who underwent gonadectomy from low middle income country.

Method: Retrospective data was obtained from children who are followed up in a single center since 2013

Results: There were nine patients who underwent bilateral gonadectomy. Age at presentation varied from 8 years to 15 years. Seven patients (77%) underwent surgery due to risk of malignancy. Age at surgery varied from 11-15 years. All of them had turner phenotype who presented with short stature. They had mosaic karyotype with Y chromosome. One patient had ambiguous genitalia. Two patients who presented late had gonadoblastomain situ. Two patients underwent surgery to prevent hormone production discordant to the gender. One of them underwent surgery before presenting to endocrinology unit, at the age of 1 year. She is well adjusted to the current gender and has no regret over the decision taken in the past without her consent. Other patient received appropriate counselling prior to surgery at 16 years. She presented at 14 years with virilization and wished to continue as a female. She is awaiting genital reconstruction surgery. Gonadectomy was delayed till she was competent to give consent. Until such time she received GnRH analogues and estrogen therapy. Only two patients were old enough to give consent. Five patients received age-appropriate explanation prior to surgery. There were no post-surgical complications. All patients had started hormone replacement therapy.

Conclusion: The commonest reason for the gonadectomy in this cohort was tumor risk who presented with karyotype consistent with tuner mosaic. The decision to do surgery was late compared to published data as they presented to the unit after the age of eight. The number of patients who underwent surgery to prevent hormone production discordant to the gender were relatively low. Further prospective studies are needed to understand reasons and long term effects of gonadectomy in adolescents.