Crossed paths: a systematic review unveiling patterns in crossed testicular ectopia

Area of Science:

• Reproductive Medicine
• Pediatric Surgery
• Urology

Background:

• Crossed testicular ectopia (CTE) is a rare congenital anomaly where both testes descend into a single hemiscrotum.
• Previously considered exceedingly rare, recent case reports suggest CTE may be more prevalent.
• CTE is frequently associated with other congenital abnormalities, notably persistent Mullerian duct syndrome (PMDS), impacting fertility.

Purpose of the Study:

• To systematically review and clarify the impact of CTE on fertility.
• To analyze histopathological findings associated with CTE.
• To identify congenital abnormalities and potential long-term outcomes in CTE patients.

Main Methods:

• A systematic literature review was conducted, including case reports, case series, and meta-analyses with individual patient data.
• Studies published in English were included.
• Data on demographics, diagnosis, histology, and fertility were extracted by two independent reviewers.

Main Results:

• 417 cases of CTE were identified, a significant increase from prior reviews.
• Histological abnormalities were present in 66% of cases, including testicular dysgenesis and malignancy.
• Infertility was reported in 79.2% of patients; PMDS was the most common associated anomaly (33.3%).

Conclusions:

• CTE is a complex condition with significant fertility and cancer risks, often underdiagnosed.
• Early diagnosis and intervention are crucial for improving patient outcomes.
• Further research into genetic factors and optimized diagnostic protocols for CTE is warranted.