Laparoscopic gonadectomy in a kidney transplant patient with pure gonadal dysgenesis: a case report.

BACKGROUND Laparoscopy has been successfully used following renal transplantation for many procedures, including native kidney nephrectomy, revision of transplant ureters and cholecystectomy. Laparoscopic surgery has also been used recently to treat pelvic disorders in patients after renal transplantation, such as removal of endometriotic cyst and hysterectomy. In such cases, we must pay special attention to the anatomy of the renal graft transplanted into the pelvic cavity. CASE A woman received a kidney transplant at 7 years old, with her mother as the donor. At 19 years old, she was diagnosed with pure gonadal dysgenesis and began hormone replacement therapy and monitoring of tumor markers. At 23 years old, laparoscopic gonadectomy was performed under general anesthesia. Bilateral atrophic gonads were removed without any complications. The renal graft in the right hemipelvis did not obstruct the operation. CONCLUSION To our knowledge, this case is the first published report of laparoscopic castration in a patient with a sexual differentiation disorder and prior renal transplantation.