A 20-year-old woman referred to our hospital for further examination of primary amenorrhea with high levels of testosterone (998 ng/ml). Inspite of having normal female external genitalia, she had 5 cm deep blind-ending vagina, absence of uterus and ovaries with the karyotype of 46,XY. Abdominal magnetic resonance imaging localized bilateral intra abdominal structures, which indicated bilateral testes. Thus, she was diagnosed with androgen insensitivity syndrome(AIS) based on both clinical and karyotypic evidence. She underwent laparoscopic bilateral gonadalectomy through a single incision at the navel and histological examination showed intratubular germ cell neoplasia (ITGCN). Her postoperative course was uneventful with less pain and a small surgical wound was only at the navel. Laparoendoscopic single site surgery (LESS) can be considered a surgical procedure for gonadalectomy in AIS patients.
Hinyokika kiyo. Acta urologica Japonica 11/2011; 57(11):657-60.