Perineal Ectopic Testis in an Adult

Abstract

Testicular maldescent may be cryptorchid with descent being arrested along its normal pathway resulting in an abdominal, inguinal or high scrotal testis, or it may stray from the normal descent to settle in an ectopic site outside the scrotum; such as the perineum, pubic region, dorsum of the penis, femoral region, anterior abdominal wall and the contralateral scrotum. Management is orchidopexy through an inguinal crease incision as the length of the spermatic cord is normal. We report a 26 year old man with a left perineal testis who underwent orchidopexy as the testicular volume was normal.

Ectopic testis: an experience of a tertiary-level urology center at Upper Egypt

“…Perineal ectopic testis is the commonest form of the non-inguinal testicular ectopia. An observation has been made from the reported cases in the literature and the current series that the perineal testis presents in a relatively older age than the other variants [13,14,25]. This finding could be attributed to the anatomical nature of the perineum where it could be missed on physical examination at early presentation.…”

“…Delayed presentation and diagnosis of testicular ectopia may come from different causes including inaccurate physical examination, non-specialized physicians, and lack of awareness of the primary healthcare physicians and families regarding these anomalies. Testicular ectopia has higher potential risks of infertility, malignancy, trauma, and torsion [1,2,13,27]. In the current cases, two patients with a unilateral ectopic testis had infertility.…”

“…In the current cases, two patients with a unilateral ectopic testis had infertility. Similarly, infertility has been reported with cases of unilateral ectopic testes [13,14]. Although the post-pubertal ectopic testis may have a fairly normal size, it is prone to have markedly deficient spermatogenesis.…”

“…The line of testicular descent extends from the level of the lower pole of the kidney to the level of the scrotal neck. Any location of the testis outside this pathway should be classified as testicular ectopia [4,12,13]. However, clinically palpable extrascrotal testes should be examined meticulously to differentiate undescended, retractile, ectopic, and ascending testes from each other, with assistance of the other tools of diagnosis, because management could be different [1,2].…”

“…However, a new classification should be implemented to withstand all the reported sites of testicular ectopia including the anterior abdominal wall ectopic testes for differentiation from the other entities of abnormal testicular descent [6,7,15]. Age of presentation of testicular ectopia is variable between the neonatal period and adulthood [13,14,16]. Abdominal positions of testicular ectopia are extremely rare, where a few cases have been reported so far [4].…”