GYNAECOMASTIA: MANAGEMENT IN A DEVELOPING COUNTRY

Authors

  • Ambreen Muneer
  • Zameer Hussain Laghari
  • Abdul Razaque Shaikh
  • Qamber Ali Laghari

Abstract

Background: Gynaecomastia is a benign enlargement of male breast. It is common in the generalpopulation, resulting from various pathophysiological mechanisms. The aim of this study was todescribe the presentation and outcome of treatment for gynaecomastia at a University Hospital inPakistan. Methods: A three year retrospective study was carried out of one hundred men withgynaecomastia. Patients were evaluated in detail clinically and by appropriate investigations. They werecounselled and kept on hormonal therapy for three months. Surgery was considered for patients withlong standing gynaecomastia, failed medical therapy and for cosmetic reasons. Post operativecomplications and patient’s satisfaction was assessed. Results: Most (90%) cases were idiopathic.Other causes were liver cirrhosis in 4 cases, testicular tumour in two, thyrotoxicosis in one and druginduced (use of cimetidine and Kushta) in two. Carcinoma of the breast was diagnosed in one patient.Most of the patients had bilateral, non tender lump in the breast. Three cases of idiopathicgynaecomastia resolved on danazol. Eighty-eight cases underwent surgical treatment. The mean age ofpatients who underwent surgery (n=88) was 30.5±9.59 years. Most of the patients belonged to 21–30years age group. Major indications for surgery were failure of medical treatment (45.5%) and cosmeticreasons (34.0%). Mean operating time for subcutaneous mastectomy was 42.2±3.70 (36–48) minutes.Mean hospital stay after subcutaneous mastectomy was 5.2±2.44 (2–10) days. The only postoperativecomplication noted was wound infection (24%). Seventy-two (81.8%) were satisfied with the results oftheir surgical treatment. Conclusion: Gynaecomastia is the common condition affecting male breastsand most common cause of gynaecomastia is idiopathic. Secondary gynaecomastia may regress in sizeby treating the primary cause. Idiopathic gynaecomastia do not respond to danazol so they neededsurgical treatment. Subcutaneous mastectomy through a periareolar skin incision is a valid procedurefor treatment for gynaecomastia and provides satisfactory cosmetic results.Keywords: Gynaecomastia, Male breast, Management, Subcutaneous mastectomy

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Published

2009-09-01

Issue

Vol. 21 No. 3 (2009): JOURNAL OF AYUB MEDICAL COLLEGE, ABBOTTABAD

Section

ORIGINAL ARTICLE

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