title: Transverse testicular ectopia: three additional cases and a review of the literature.
abstract: OBJECTIVE
  Transverse testicular ectopia (TTE) is a well described, rare congenital abnormality of testicular descent, in which both testes migrate through one inguinal canal. The objective of this work was to present three cases of TTE, one of them with a common vas deferens. To our knowledge, a fused vas deferens has only been reported four times in previously published reports.
  
  
  METHODS
  Three patients presented with inguinal hernia and contralateral cryptorchidism. In case 1, the diagnosis of TTE was made preoperatively by palpating two testes in one hemiscrotum. The diagnosis of case 2 was made intraoperatively and was found to be of a rare form in which the two vasa deferentia fused in the inguinal canal to form a common vas deferens. The diagnosis of case 3 was also done intraoperatively and a laparoscopy was performed to document the anatomy of TTE and to rule out the presence of Müllerian duct remnants. We also performed a literature search for other reports of TTE.
  
  
  RESULTS
  The three cases were operated with trans-septal orchidopexy. In addition, laparoscopy was performed in case 3 to clarify the anatomy. Biopsy revealed normal testicular tissue from both testes in the first two patients. Follow-up with ultrasound, 6 months after operation showed normal size and blood flow of both testes.
  
  
  CONCLUSIONS
  Transverse testicular ectopia should be suspected in a boy with an inguinal hernia and contralateral non palpable testis. Trans-septal orchidopexy is recommended when vasa deferentia are fused. Laparoscopy is useful to document the anatomy and to rule out the presence of Müllerian remnants.
authors.affiliation: Department of Pediatric Surgery, Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden. hussain.naji@karolinska.se
authors.forename: Hussein
authors.initials: H
authors.lastname: Naji
authors.forename: Alexander
authors.initials: A
authors.lastname: Peristeris
authors.forename: Jakob
authors.initials: J
authors.lastname: Stenman
authors.forename: Jan F
authors.initials: JF
authors.lastname: Svensson
authors.forename: Tomas
authors.initials: T
authors.lastname: Wester
mesh_terms: D002675:Child, Preschool; D003456:Cryptorchidism / Q000150:complications / Q000175:diagnosis / Q000601:surgery; D003937:Diagnosis, Differential; D005500:Follow-Up Studies; D006552:Hernia, Inguinal / Q000150:complications; D006801:Humans; D007223:Infant; D008297:Male; D056126:Orchiopexy / Q000379:methods; D013733:Testicular Diseases / Q000150:complications / Q000175:diagnosis* / Q000601:surgery*; D013737:Testis / Q000002:abnormalities / Q000000981:diagnostic imaging / Q000601:surgery; D016896:Treatment Outcome; D014463:Ultrasonography; D014649:Vas Deferens / Q000002:abnormalities