Transverse testicular ectopia: two rare adult cases and a review of literature

BMJ Case Rep. 2020 May 6;13(5):e232240. doi: 10.1136/bcr-2019-232240.

Abstract

The first case is a 45-year-old man who presented with complaints of right-sided indirect hernia. On examination the left hemiscrotum was empty. Open hernioplasty and mesh fixation with orchiopexy of both testes were done in the same hemiscrotum, followed by MRI for further evaluation. The second case is a 26-year-old man who presented with penoscrotal hypospadias and empty left hemiscrotum, with the left testis not palpable in the scrotum or the inguinal region. MRI, karyotyping and laparoscopic orchidectomy were performed, followed by endocrinology work-up. From our experience, preoperative diagnosis with ultrasonography and/or MRI prior to diagnostic laproscopy is benifical when there is a strong suspicion of mullerian duct remnants. In other cases, diagnostic laparoscopy can be useful in diagnosis and management. Placement of both testes in the same hemiscrotum can be considered safe, although not ideal. Also, in cases with partial gonadal dysgenesis, laparoscopic orchidectomy along with excision of the mullerian remnantsis a better approach than orchiopexy.

Keywords: endocrine system; sexual and gender disorders; surgery; urinary and genital tract disorders; urological surgery.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Cryptorchidism / diagnostic imaging
  • Cryptorchidism / surgery*
  • Diagnosis, Differential
  • Hernia, Inguinal / diagnostic imaging
  • Hernia, Inguinal / surgery*
  • Herniorrhaphy
  • Humans
  • Male
  • Middle Aged
  • Orchiectomy
  • Orchiopexy
  • Testis / abnormalities*
  • Testis / diagnostic imaging
  • Testis / surgery*