睾丸女性化综合征的诊断与治疗

目的：探讨睾丸女性化综合征的诊断和治疗原则。方法：回顾性分析5例睾丸女性化综合征患者的临床资料。结果：5例睾丸女性化综合征患者均行睾丸切除术，其中1例尚行阴道成形术，术后均能进行性生活。结论：对睾丸女性化患者而言，明确的诊断和合适的治疗是非常重要的。     

睾丸女性化综合征6例报告

目的 总结6例睾丸女性化综合征的诊断及治疗体会。方法 回顾性分析6例睾丸女性化综合征的诊断方法、治疗措施及结果。6例均行睾丸切除术，5例行阴蒂矫形术。术后均长期服用雌激素治疗。结果 6例术后均恢复顺利。1例失访。余5例术后外生殖器外观满意，感觉良好。其中1例已婚，性生活满意。结论 本病一般作女性处理，双侧睾丸应切除，术后长期服用雌激素。     

睾丸女性化症诊治探讨(5例报告并文献复习)

目的探讨睾丸女性化症的临床特征和诊治方法。方法总结5例临床确诊的睾丸女性化症的外形表现、血浆性激素检查、影像学检查、染色体核型等临床资料和治疗过程,结合文献资料分析和讨论睾丸女性化症的特征和诊治方法。结果5例睾丸女性化症均经双侧隐睾切除术,术后给予雌激素补充治疗和心理辅导,效果较好。结论睾丸女性化症临床并不罕见,手术时间的选择对治疗有重要意义,手术后的激素补充和心理治疗十分重要。     

睾丸女性化综合症

睾丸女性化综合症(Codberg-Maxwell综合症),又名男性假两性畸形,是一种少见的先天性遗传性疾病。患者具有睾丸而体型呈女性型,外阴酷似女性,阴道短浅呈盲管,但内生殖器无苗勒氏管衍生物(子宫、输卵管及阴道上部),亦无男性生殖管道。我院于1981年8月至1986年6月共收治本病患者8例。现报告如下。临床资料一、一般资料年龄16—32岁,平均23.6岁。社会性别女性。8例中3例已婚,其中例_1、例_2结婚已达12年。所有患者的体态包括乳房发育、外阴均为女性,阴道为6—7厘米盲管,无宫颈及子宫。从无月经来潮。染色体为46XY。B超检查盆腔内无子宫。腹股沟及大阴唇处有肿块为发育不良的睾丸(附表)。     

睾丸女性化综合征患者的临床特征

睾丸女性化综合征为男性假两性畸形 ,临床上不常见。本病患者性腺是睾丸 ,外阴呈女性表现。由于阴囊以外的男性性腺容易发生恶性变 ,故早期诊断、早期治疗具有重要的临床意义。 1 985～ 2 0 0 1年 ,我们收治睾丸女性化综合征患者 6例。为了深化对本病的认识 ,提高患者生活质量 ,现将患者临床特征分析如下。1　资料与方法1 .1 　 临床资料本组 6例 ,年龄 9～ 2 6岁 ,平均 1 8.6岁 ,其中 5例为成人患者 ,社会性别均为女性。 4例主诉为原发性闭经、1例外生殖器发育不正常收治入院 ;1例为普外科行双侧疝修补术中发现睾丸。全部患者外周静脉血染…     

苗勒管永存综合征（2例报告并文献复习）

目的：探讨苗勒管永存综合征（PMDS）的病因、临床表现、诊断和治疗。方法：报告2例PMDS。1例伴睾丸横过异位；另1例伴隐睾。伴隐睾者予隐睾切除，两者均接受子宫体大部切除和睾丸固定术。结果：随访1.5-2年，2例患者睾丸质地、血流均正常。结论：PMDS为一种男性假两性畸形，治疗应力求保护睾丸的血供和生殖功能，并密切随访。     

闭合性睾丸损伤13例报告

目的探讨闭合性睾丸损伤的诊断和治疗水平。方法对手术或保守治疗的13例闭合性睾丸损伤患者进行随访和分析，比较其治疗效果。结果手术治疗组10例，8例获随访6月-24月。5例睾丸容积较对侧小。未见睾丸萎缩。保守治疗组3例中2例获随访24月，睾丸萎缩；另1例睾丸切除者失访。结论闭合性睾丸损伤除小的单纯性阴囊血肿可保守治疗外，对大而增长较快的血肿均应手术探查，清除血肿，充分引流，修补破裂的睾丸，避免发生睾丸萎缩及生精障碍。     

成人睾丸良性肿瘤的诊断与治疗(附15例报告)

目的：探讨成人睾丸良性肿瘤的诊断与治疗方法。方法：对1993～2005年间收治的15例睾丸良性肿瘤患者的临床资料及预后情况进行回顾性分析。结果：多为体检时发现睾丸肿物,MRI、B超及术中冷冻切片活检是其主要诊断方法;行睾丸切除术3例,保留睾丸的肿瘤切除术12例,病理检查证实表皮样囊肿9例,支持细胞瘤2例,支持细胞-间质细胞瘤3例,间质细胞瘤1例。术后2个月～11年随访,无复发及恶变。结论：睾丸良性肿瘤的术前诊断应引起足够重视,B超、MRI及术中冷冻切片活检具有临床诊断价值;治疗首选保留睾丸的肿瘤切除术,这对于患者术后生理及心理方面均具有重要意义。     

前列腺增生症睾丸切除术后远期疗效观察

目的：探讨前列腺增生症（BPH）睾丸切除术后的远期疗效。方法：对16例在5年前进行睾丸切除术的BPH尿潴留患者进行随访，测量前列腺体积和观察排尿症状的变化。结果：睾丸切除术后5年增生前列腺体积缩小33．4％，其中12例患者排尿通畅（75．0％），剩余尿量平均28ml，1例改为膀胱造口；3例佐以α-受体阻滞剂治疗。结论：睾丸切除术后增生的前列腺发生永久性萎缩，该方法可使大部分BPH尿潴留患者缓解症状。     

延长尿道口-阴道口间距治疗女性尿道综合征50例

目的：探讨治疗女性尿道综合征的手术方法及可行性。方法：对50例女性尿道综合征患者采用延长尿道口-阴道口间距进行治疗。结果：除5例失随访外，余45例(90％)全部得到随访，痊愈者38例(84％)，好转4例(9％)，差3例(7％)，痊愈38例中，术后3个月内痊愈者8例，4--6月13例，7-12月12例，1--2a 5例，平均8月，总有效率达到93％。结论：此术式治疗女性尿道综合征，简单，安全、可行，疗效满意。     

Testicular feminization syndrome current clinical considerations

The testicular feminization syndrome (TFS) in its complete form results in total feminization due to a nuclear in action of androgens, and the female role should be supported with postpubertal orchiectomy to avoid the risk of malignancy. Incomplete forms of the syndrome (ITFS ) include Type I in which some degree of masculinization may be observed, prompting earlier gonadectomy, and Type II or pseudovaginal perineoscrotal hypospadias (PPSH) which is always characterized by pubertal masculinization, necessitating management and support of these patients as males. Other intersex abnormalities which must be differentiated include true hermaphroditism, the Swyer syndrome males with 17-ketosteroid reductase deficiency, and Reifenstein's syndrome.     

Laparoscopic bilateral orchiectomy for testicular feminization syndrome.

A 13-year-old female patient with complete androgen insensitivity (testicular feminization syndrome) had an excision of bilateral intra-abdominal testicles via the laparoscopic approach. The patient had a very smooth, fast recovery from her surgery. The laparoscopic approach should be considered for most patients in need of surgical removal of undescended or intra-abdominal testes.     

LAPAROSCOPIC GONADECTOMY FOR TESTICULAR FEMINIZATION SYNDROME

Laparoscopic gonadectomy was performed on a patient with complete androgen insensitivity (testicular feminization syndrome). In the case presented here, although the gonads were free, the omentum which was adhering to the right inguinal ring, possibly as a result of previous inguinal hernia repair, obscured the right gonad. The left gonad was located behind the sigmoid colon. We present our laparoscopic experience in managing this case of testicular feminization syndrome.     

Irreducible inguinal hernia,bowel obstruction,and torsion of testis in a patient with testicular feminization syndrome

Testicular feminization syndrome, irreducible inguinal hernia, bowel obstruction, and testicular torsion were diagnosed and treated in a 13-year-old girl. Diagnosis of this case in such a complex form in an emergency room is a rare occurrence. Through this case, we want to emphasize the coincidence of inguinal hernia and testicular feminization and the X-linked recessive transmission character of the disease.     

Clinical aspects of testicular carcinoma-in-situ

Carcinoma-in-situ germ cells were demonstrated in testicular biopsies from 9 of 826 patients (1.1%) from a selected group of Danish infertile men. A similar observation was noted in testicular biopsies from 9 Swiss patients (representing 0.55% of the total number of infertile patients biopsied in that study). Such changes were also seen in 8 testicular biopsies from the contralateral testis of 180 patients (4.4%) with carcinoma of the teitis. Moreover, carcinoma-in-situ has beer, found in maldecended testes and in gonads of patients with the testicular feminization syndrome although the incidence of carcinoma-in-situ in these two latter groups is unknown.
The malignant potential of carcinoma-in-situ of the testis in infertile men has been clearly demonstrated, whereas its clinical significance in other groups of patients remains to be determined.     

A case of testicular feminization

A 21-year-old female visited the gynecological clinic because of primary amenorrhea. The patient was a phenotypic female with scanty pubic hair, short and blind-ending vagina and bilateral inguinal soft masses. The patients was referred to our clinic. The serum luteinizing hormone level was 27.1 mIU/ml, follicle stimulating hormone level was 8.8 mIU/ml, and testosterone level was 11 ng/ml. Chromosomal analysis of peripheral lymphocytes revealed the karyotype 46, XY. The pathological specimens of bilateral inguinal masses showed atrophic testis without spermatogenesis and with Sertoli's cell nodular hyperplasia. The diagnosis of testicular feminization was established.