left spermatic cord. After slight mobilization of the ectopic Case report right testis, a trans-septal orchidopexy was easily performed. Histopathological examination of tissue from A 21-year-old man presented with infertility and a past history of an unsuccessful inguinal exploration for right both testes showed maturation arrest. Because of the reported association of Mü llerian duct anomalies in such cryptorchidism. On clinical examination he had normal primary and secondary sexual characters except for an cases, he later underwent a laparoscopic examination, when none were found. empty right hemiscrotum. The left testis and the spermatic cord were bulky, which is not an uncommon finding in India as filariasis is endemic. He also had an Comment associated left indirect inguinal hernia. His semen examination showed azoospermia and the presence of fructose.Crossed testicular ectopia is a rare congenital abnormality and only 17 cases have been reported in the He underwent herniorrhaphy and a testicular biopsy, after which a scrotal exploration revealed that there medical literature over the last 15 years. There is no record of knotting of the spermatic cords with fusion of were two equal-sized testes firmly adherent to each other inside a single tunica vaginalis. Each testis had a separate the testes in any of these cases, although fusion of the vasa deferentia with or without duplication has been cord with a normal vas but the cords were tied in a loose knot (Fig. 1). Apart from an adhesion in a small reported in three [1]. The development of crossed testicular ectopia can be illustrated by reversing the operative area, the cords were otherwise completely free. The testes were easily separated by cutting the fibrous avascu-procedure. The orthotopic testis underwent a 180°torsion to form a loop in its cord. The ectopic right testis lar adhesions with scissors, with no damage to the tunica albuginea (Fig. 2). The spermatic cords were untied by with a 'clapper bell' deformity passed through this loop to form a knot, mimicking a method commonly practised passing the ectopic right testis through the loop of the by Gaur to form a laparoscopic knot [2]. The testicular a a d b c Fig. 2. The loop b, formed by the cord of the orthotopic testis a, Fig. 1. The fused testes with the knotted cords, just delivered from after the testes were separated. The cord d, of the ectopic right testis c, can be seen passing through the loop. the left scrotum. 924

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A patient with Sotos syndrome presented with a history of massive bleeding from varicose veins of the right leg, requiring hospitalization. Investigations revealed that his bilateral varicose veins and the associated leg edema were secondary to the inferior vena cava getting compressed by an asymptomatic grossly hydronephrotic right kidney. The patient was completely cured of his varicosity and leg edema following retroperitoneal laparoscopic nephrectomy. A giant hydronephrosis has produced venous thrombosis in the past, but this is the first time it was found to be responsible for bilateral varicosity of the long and the short saphenous veins due to long-standing vena caval compression.