Transverse testicular ectopia: a rare association with inguinal hernia

Area of Science:

• Urology
• Pediatric Surgery
• Medical Imaging

Background:

• Transverse testicular ectopia (TTE) is a rare congenital anomaly where both testes are located on the same side of the scrotum.
• TTE is frequently associated with inguinal hernias, particularly in pediatric cases.
• Adult cases of TTE are exceptionally rare, with limited literature available.

Observation:

• A 42-year-old fertile male presented with a reducible left inguinal hernia.
• Intraoperative findings revealed a left indirect inguinal hernia with transverse testicular ectopia, both testes residing on the left side.
• The patient underwent successful hernioplasty and bilateral orchidopexy.

Findings:

• This case represents one of the few documented instances of TTE in an adult male.
• The diagnosis of TTE was made intraoperatively, underscoring the challenges in preoperative identification.
• While ultrasonography (US) and magnetic resonance imaging (MRI) show promise for preoperative diagnosis, US failed to detect TTE in this patient.

Implications:

• The case emphasizes the importance of considering TTE in adult males presenting with inguinal hernias, even if rare.
• Intraoperative diagnosis remains crucial for managing TTE, especially when imaging is inconclusive.
• Further research into advanced imaging techniques may improve preoperative detection rates for TTE in adults.