Tanabe Kan, Mori Shinichiro, Kita Yoshiaki, Wada Masumi, Kenji Baba, Itaru Omoto, Takaaki Arigami, Satoshi Iino, Kosei Maemura, Natsugoe Shoji
Department of Digestive Surgery, Breast and Thyroid Surgery Graduate School of Metical Sciences Kagoshima University, Kagoshima, Japan.
Department of Digestive Surgery, Imamura General Hospital.
Medicine (Baltimore). 2020 Feb;99(7):e19079. doi: 10.1097/MD.0000000000019079.
Persistent Müllerian duct syndrome (PMDS) is a rare disease occurring in men with an otherwise completely normal phenotype, in which female internal sex organs are present, including a uterus, fallopian tubes, cervix, and vagina. We report a case of bilateral recurrent inguinal hernia due to PMDS treated by transabdominal preperitoneal repair (TAPP).
A 72-year-old male presented with a complaint of swelling on both sides of the groin. The patient had undergone bilateral inguinal hernia suture repair 50 years ago.
Bilateral recurrent inguinal hernia INTERVENTIONS:: TAPP was performed. There was a fibrous structure linking the left and right hernia orifice and a muscular structure in the hernia sac on the left. We noticed that the muscular structure was a vagina and fibrous structure was the salpinx, and we diagnosed the patient with PMDS. Supravaginal hysterectomy and right salpingectomy were performed. After that a preperitoneal mesh repair was performed for bilateral inguinal hernia.
Histologically, the diagnosis was confirmed as PMDS. The patient had an uneventful recovery.
This case is the first case of bilateral recurrent inguinal hernia due to PMDS managed by TAPP.
持续性苗勒管综合征（PMDS）是一种罕见疾病，发生于具有完全正常表型的男性，其体内存在女性内生殖器，包括子宫、输卵管、子宫颈和阴道。我们报告一例因PMDS导致双侧复发性腹股沟疝，经腹腹膜前修补术（TAPP）治疗的病例。
一名72岁男性因双侧腹股沟肿胀前来就诊。该患者50年前曾接受双侧腹股沟疝缝合修补术。
双侧复发性腹股沟疝
实施TAPP手术。发现左侧疝囊内有连接左右疝孔的纤维结构和肌肉结构。我们注意到该肌肉结构为阴道，纤维结构为输卵管，诊断该患者为PMDS。行阴道上部子宫切除术和右侧输卵管切除术。之后对双侧腹股沟疝进行腹膜前补片修补术。
组织学检查确诊为PMDS。患者恢复顺利。
该病例是首例因PMDS导致双侧复发性腹股沟疝并采用TAPP治疗的病例。
