An uncommon case of transverse testicular ectopia presented as unilateral inguinal hernia: uncover impact of laparoscopy and management options

Abstract

Transverse testicular ectopia (TTE) is an extremely rare congenital anomaly in which both testes descend through the same inguinal canal. Patients with this condition often present with an inguinal hernia and an impalpable contralateral testis. This condition is not usually diagnosed preoperatively and the ectopic testis is usually discovered incidentally during herniotomy or findings are noted at the time of diagnostic laparoscopy. Sometimes but not commonly, TTE cases associated with intersex conditions like persistent Mullerian syndrome, which may prevent normal testicular decent. Here, we report a four year old male child presented with impalpable left undescended testis and right inguinal hernia. Diagnostic laparoscopy revealed closed left internal ring with absence of vas deferens and testicular vessels. While on the right side, vas and vessels found to be entering the wide open internal ring and left testis was located just inside the ring with its own vas and vessels supply. Consequently, trans-septal contralateral orchidopexy involving fixing the right testis in left hemiscrotum as right testis had adequate cord length and left testis was fixed in the right hemiscrotum due to its short cord length was done.