Laparoscopic management of transverse testicular ectopia with persistent mullerian duct syndrome

Abstract

A 4-month-old male child presented with right undescended testis and left inguinal hernia with funiculitis. Ultrasonography showed funiculitis on the left side testis along with presence of 1.5 × 1 cm testis like structure just above left testis and empty right scrotal sac without any evidence of mullerian structures. On diagnostic laparoscopy, right testicular vessels were crossing from right to left and had uterus with both testes in left hernia sac. Mobilization of vessels, division of uterus, and hernia repair was done laparoscopically. On the review of literature, there is only one case report of total laparoscopic repair of transversetesticular ectopia (TTE) with hernia without persistent mullerian duct (PMDS). The uniqueness of our case is that it had TTE with hernia and PMDS, which were totally managed by laparoscopy. On 6 months of follow-up, both the testes are palpable in scrotum.

Right Transverse Testicular Ectopia: A Nonclassified Variant Confirmed on Laparoscopy

“…Still, some authors advocate complete dissection to individualize the testes and spermatic cords with transseptal or extraperitoneal orchidopexy through an inguinal or scrotal approach [18]. Laparoscopic surgery with or without inguinal exploration has been described for management of TTE and associated anomalies in staged or single procedures [23,24]. We used laparoscopy for diagnosis and then a scrotal approach to explore the left hemiscrotum and successfully placed both testes in separate scrotal compartments through a transseptal orchidopexy.…”

Transverse testicular ectopia with fused vas deferens: A case series

“…Mobilization of fused cord or vas and excising PMD remnants are challenging, and extended inguinal exploration with trans-septal orchidopexy (Ombredanne or modified procedure) [Figure 3] is often necessary; however, this has been managed laparoscopically as well. [1112] Laparoscopy is now being increasingly used for diagnosis and correction of TTE and PMD remnants excision. Frequently, the vas and the PMD remnants are joined together, but laparoscopic dissection of these structures is feasible and can minimize the damage to vas.…”

Transverse testicular ectopia with persistent mullerian duct syndrome

“…Hutson et al classified PMDS into three groups 1. Group A is the female type where testes are in position of normal ovaries.…”

“…Kamble et al 1 were the first to describe total laparoscopic repair for TTE with PMDS in 2015. Laparoscopy is now becoming the route of choice for management of such cases.…”