Mp72-02 Transverse Testicular Ectopia and Persistent Müllerian Duct Syndrome in Pediatric Patients: Multicentric Series Study of a Rare Condition

You have accessJournal of UrologyPediatrics VII (MP72)1 May 2024MP72-02 TRANSVERSE TESTICULAR ECTOPIA AND PERSISTENT MÜLLERIAN DUCT SYNDROME IN PEDIATRIC PATIENTS: MULTICENTRIC SERIES STUDY OF A RARE CONDITION Francisco Reed, Marco Perez-Branfyl, San Juan, Puerto Rico, Ahmet Sancaktutar, Yolanda Pullin, Juan Carlos Prieto, Pankaj Dangle, Juan Manuel Moldes, and Pedro-Jose Lopez Francisco ReedFrancisco Reed , Marco Perez-BranfylMarco Perez-Branfyl , San JuanSan Juan , Puerto RicoPuerto Rico , Ahmet SancaktutarAhmet Sancaktutar , Yolanda PullinYolanda Pullin , Juan Carlos PrietoJuan Carlos Prieto , Pankaj DanglePankaj Dangle , Juan Manuel MoldesJuan Manuel Moldes , and Pedro-Jose LopezPedro-Jose Lopez View All Author Informationhttps://doi.org/10.1097/01.JU.0001009572.60675.69.02AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Transverse Testicular Ectopia (TTE) is a rare form of undescended testicles, and even rarer in association with Persistent Müllerian Duct Syndrome (PMDS). These are two distinct anomalies where testicular ectopia is described as one testicle crossing the scrotal septum or descending into the opposite inguinal canal towards the same hemiscrotum, and in some cases associated with persistent Müllerian structures. We describe six cases of TTE, their surgical approach for testicular descent and a recommendation for the approach in these cases. METHODS: Medical records of six patients with TTE resolved in 6 different centers were reviewed. All 6 case reviews included at least one year of post-operative follow-up. RESULTS: All patients were diagnosed clinically and with an ultrasound. All 6 cases underwent a laparoscopic approach. Two patients had a laparoscopic 2-stage Fowler Stephens; one of these with Prentiss maneuver for testicular positioning and the other had a transseptal repositioning of the testes at the 2nd stage. Two other patients had the testes repositioned with a single Fowler Stephens laparoscopic surgery. The last 2 patients, after laparoscopic exploration with evidence of both structures passing into one inguinal ring, had an open inguinal orchiopexy and repositioning of testicles through the midline scrotal septum in each side of the scrotum. In this series 3/6 patients had PMDS, without resection of the Müllerian remnants as they were in close relation whether with irrigation of the testes or the vas deferens. Post-operative testicular ultrasound performed after 1 year of follow-up in all patients revealed homogenous testicular echogenicity with adequate volume and location of the gonads within the scrotal sac. CONCLUSIONS: Transverse Testicular Ectopia (TTE) is a rare condition with few described cases. This is a multicentric series reporting 6 cases. TTE and PMDS anomalies may be encountered during surgery for undescended testicle and/or inguinal hernia; thus, it should not be overlooked. Each case of TTE and PMDS is unique and should be approached and managed based on the individual anatomy and surgical findings, with the final aim to reposition each teste in each hemiscrotum (even if they are in the same inguinal canal). In these cases, laparoscopic abdominal exploration is the first surgical approach recommended, followed by correction of cryptorchidism. Even though surgical removal of persistent Müllerian remnants is recommended, it could be part of the TTE, so it may be necessary to leave it intact. Source of Funding: No © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e1171 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Francisco Reed More articles by this author Marco Perez-Branfyl More articles by this author San Juan More articles by this author Puerto Rico More articles by this author Ahmet Sancaktutar More articles by this author Yolanda Pullin More articles by this author Juan Carlos Prieto More articles by this author Pankaj Dangle More articles by this author Juan Manuel Moldes More articles by this author Pedro-Jose Lopez More articles by this author Expand All Advertisement PDF downloadLoading ...