期刊
EUROPEAN JOURNAL OF ENDOCRINOLOGY
卷 184, 期 6, 页码 791-801出版社
BIOSCIENTIFICA LTD
DOI: 10.1530/EJE-20-1058
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资金
- NIHR Cambridge Biomedical Research Centre
- Ghent University Hospital
- MHAT Sveta Marina, Varna
- Copenhagen University Hospital, Rigshospitalet
- Universitatsklinikum Schleswig-Holstein
- Azienda Ospedaliera Sant'Orsola Malpighi, Bologna
- Leiden University Medical Centre
- Radboud University Nijmegen Medical Centre
- Erasmus Medical Centre Rotterdam
- Karolinska University Hospital, Stockholm
- University Hospitals Birmingham NHS Foundation Trust
- NHS Greater Glasgow and Clyde Board
- Central Manchester University Hospitals NHS Foundation Trust
- University Hospital Southampton NHS Foundation Trust
This study examined trends in clinical practice for individuals with DSD requiring gonadectomy and found that the likelihood of gonadectomy depends on the underlying diagnosis, sex of rearing, and geographical setting. Variations in the practice of gonadectomy were observed among different countries.
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 centre; and location of centre 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 centres. 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 centres 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 (7 6%). 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 centres, 17 (5%) at 9 centres had undergo ne gonadectomy before their first presentation to the specialist centre. Median age at gonadectomy of cases from high-income countries and low-/middle-income countries (LMIC) was 13.0 years (0.1, 68) years and 16.5 years (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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