A Case Report on Unilateral Double Testicles

Abstract

A unilateral double testicle is a rare anomaly characterized by migration of one testicle towards the opposite inguinal canal. The commonest erratic development is the more or less incomplete descent of the testicle along the normal route of descent, which is known as cryptorchidism. In ectopia of the testicles, as opposed to cryptorchidism, the displaced testicle does not descend along the usual route but as it migrates downwards it moves into an entirely abnormal position. Usually the migrating testicle remains on its own side of the body but may end up in an unusual position e.g. in the superficial tissue of the inguinal region above the external ring, in the area of the base of the penis, in the upper part of the thigh, in the region of perineum or in the pelvic cavity. In this case, the right and left testicles were found to descend together on the right side, whereas the left side of the scrotum was entirely empty. The case was treated with 'Bilateral Transeptal Subdartos Orchidopexy'. The case reported here is evidently one of extreme rarity as there are about 148 reported cases since the first described by Von Lenhossek in1886. Case report:A one year old boy presented with a painful swelling in the right groin and vomiting for 6 hours with a history of empty scrotum on the left side since birth. Physical examination showed a right sided obstructed inguinal hernia together with a palpable retractile right testicle and a non palpable left testicle and spermatic cord. Suspecting a right sided obstructed inguinal hernia and left sided cryptorchidism, he was submitted to emergency operative treatment under general anesthesia after adequate resuscitation.Operative findings as related to this unusual condition are described now. On inguinotomy, a redundant tunicavaginalis was discovered which extended for some distance proximally along the cord. During separation of the tunica vaginalis, it was found that the boy had two testicles on the same side of equal appearance, separated epididymis and vasa deferentia. The mesorchia was fused with the peritoneum. Both testicles were delivered into the inguinal wound (Fig.1). Both spermatic cords were followed to the right deep inguinal ring where they entered the abdomen. Isolation of the hernial sac was carefully done in a regular way without any injury to the spermatic cords and spermatic vessels.