Crossed testicular ectopia: Case report with review of literature

Ectopic Crossed Testis: A Rare Anomaly of Testicular Migration

Ectopic crossed testis is a rare condition in which both testes descend through the same inguinal canal. The most common presentation is an ipsilateral inguinal hernia with contralateral cryptorchidism. This is a case report of a six-year-old male child who had an empty right scrotal sac. Diagnostic laparoscopy is useful for both diagnosis and management. Management is determined by the anatomy of the vas, vessels, and testis discovered during surgical exploration. Transseptal contralateral orchidopexy results in good tension-free testicular fixation in the scrotum.

Bilateral ureteral reimplantation in a patient with an intraperitoneal ectopic bipenis: A case report

BACKGROUND

Diphallia is a highly uncommon congenital urogenital abnormality and a few connected reports have been published. However, no case of intraabdominal heterotopic diphallus has been documented to date. In the present study, we present a rare case of intraperitoneal ectopic bipenis.

CASE SUMMARY

A 49-year-old man was hospitalized with the chief complaint of hydronephrosis of both kidneys, which was discovered three days earlier through regular physical examination performed using urological ultrasound without significant lumbar or abdominal pain or bladder irritation. Physical examination showed normal external penile development, bilateral testes located on the left side of the scrotum, and a fused epididymis. Urological plain and enhanced computed tomography suggested bilateral hydronephrosis, bilateral ureters opened to the left side of the bladder wall; an intrapelvic soft tissue shadow on the left side of the bladder was considered a germline malformation called bipenis (hidden penis in the abdominal cavity). Based on the urological plain and enhanced computed tomography results, a 49-year-old man was diagnosed with bipenis (one hidden in the abdominal cavity). Ectopic penile compression produced bilateral ureteral dilatation and hydronephrosis. The ectopic penis was amputated and partially removed during surgery, and bilateral ureteral replantation was successfully performed. At a 2-mo follow-up, the patient was very satisfied with the operation, there was no significant hydronephrosis in both kidneys, and urination and erectile function were normal.

CONCLUSION

To our knowledge, this is the first report of diphallia with an intraperitoneal ectopic penis. Computed tomography or magnetic resonance imaging can be used to assess the associated internal anomalies before surgery. Postoperative pathological findings are the gold standard for the diagnosis.

Bilateral ureteral reimplantation in a patient with an intraperitoneal ectopic bipenis: A case report

BACKGROUND

Diphallia is a highly uncommon congenital urogenital abnormality and a few connected reports have been published. However, no case of intraabdominal heterotopic diphallus has been documented to date. In the present study, we present a rare case of intraperitoneal ectopic bipenis.

CASE SUMMARY

A 49-year-old man was hospitalized with the chief complaint of hydronephrosis of both kidneys, which was discovered three days earlier through regular physical examination performed using urological ultrasound without significant lumbar or abdominal pain or bladder irritation. Physical examination showed normal external penile development, bilateral testes located on the left side of the scrotum, and a fused epididymis. Urological plain and enhanced computed tomography suggested bilateral hydronephrosis, bilateral ureters opened to the left side of the bladder wall; an intrapelvic soft tissue shadow on the left side of the bladder was considered a germline malformation called bipenis (hidden penis in the abdominal cavity). Based on the urological plain and enhanced computed tomography results, a 49-year-old man was diagnosed with bipenis (one hidden in the abdominal cavity). Ectopic penile compression produced bilateral ureteral dilatation and hydronephrosis. The ectopic penis was amputated and partially removed during surgery, and bilateral ureteral replantation was successfully performed. At a 2-mo follow-up, the patient was very satisfied with the operation, there was no significant hydronephrosis in both kidneys, and urination and erectile function were normal.

CONCLUSION

To our knowledge, this is the first report of diphallia with an intraperitoneal ectopic penis. Computed tomography or magnetic resonance imaging can be used to assess the associated internal anomalies before surgery. Postoperative pathological findings are the gold standard for the diagnosis.

Crossed testicular ectopia: report of two cases in children of consanguineous parents

Crossed testicular ectopia (CTE) is an extremely rare anomaly of urogenital development. The etiopathogenic mechanism is unknown. Medical records of two biological siblings with a confirmed diagnosis of CTE being managed at our center were collected. The first patient was born with a non-palpable right teste. An exploratory laparoscopy was performed and a right CTE was found. The second patient had an incarcerated left inguinal hernia and a mesopenile hypospadias. During surgery a left CTE was observed. The parents were consanguineous. This is the first reported case of CTE in siblings.

Type 2 transverse testicular ectopia: A case report

Transverse testicular ectopia(TTE) is a rare anomaly defined by the presence of both testis in the same hemiscrotum or in the same inguinal canal.The main treatment of TTE is surgical intervention.

Here we report a case of type 2 transverse testicular ectopia in an eight months old child.

The boy had a right side inguinal hernia and a non-palpable testis on the left side. Ultrasonography confirmed the presence of both testis at the right inguinal region.

Our case was associated with the persistence of Mullerian duct.

After the excision of the Mullerian duct remnant, bilateral orchiopexy was performed.

Dorsal urethro-cutaneous fistula caused by an impacted stone at the bulbar urethra: Case report

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Penile ureteral stones constitutes less than 1% of the urinary tract stones.

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They are either primary (native) or secondary (migrated).

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Secondary urethral stones are commoner and larger in size.

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The clinical diagnosis require high index of suspicion.

Background

Penile urethral stones are very and constitutes less than 1% of the urinary tract stones and commoner in males. They are either primary or secondary. The clinical diagnosis require high index of suspicion.

Case presentation

A 30-year-old male was complaining of penile pain, weak urinary stream and dribbling at the end of micturition for 2 months, later on he developed severe dysuria and a tender nodule over the dorsal penile surface. An attempted urethral catheterization was failed. There was no history of urethral trauma or instrumentation. Examination of genitalia revealed a normal meatus with a fistula at dorsal mid penile shaft and the urine were coming out from that opening with surrounding redness and edema with palpable firm nodule in the penile shaft. A pelvic x-ray revealed a mid-urethral radiopaque shadow, cystoscopy revealed an impacted stone in mid-bulbar urethra, attempts of stone extraction was failed. An open ventral urethral incision was made and the stone was removed, dorsal fistulectomy and repair was performed. Foley's catheter was placed and removed later after 21 days. The patient had uneventful postoperative period and the follow up was done up to 6 months with no postoperative complications.

Conclusion

The clinical diagnosis of penile urethral stones require high index of suspicion. Management options are variable depending on impaction site, the size, and associated urethral pathologies. The fistula tract require excised and repair.

Triphallia (triple penis), the first reported case in human

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Supernumerary penises is an extremely rare congenital anomaly.

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It affects one in every 5–6 million live births.

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Each case has a unique presentation and no cases are identical.

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Around 100 cases of diphallia are reported till now.

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No cases of Triphallia is reported before.

Introduction

Supernumerary penises is an extremely rare congenital anomaly which affects one in every 5–6 million live births. Affected patients may have only a rudimentary penis, supernumerary penile glances or complete duplication or triplication of penises. Some patients may have some other associated congenital anomalies.

Presentation of case

A 3-month-old child presented because of left side hydrocele. There were evidence of two supernumerary penises in the perineum, the first one was about 2 cm in length with a glans and was attached to the root of the penis, and the third one was about 1 cm and was below the scrotum. Hydrocelectomy was performed. The two supernumerary penises were extending to perineal region and were attached to original penis, both had corpora cavernosum and spongiosum with no urethra inside. Both supernumerary penises were excised and both corpora were sutured with a fine slowly absorbable suture material. The patient was discharged with no postoperative events and follow up was done for one years with no reported adverse events.

Conclusion

Triphallia (three penises) is unreported condition in human until now. Patients with supernumerary penises have unique presentation and no cases are identical. The position of the penis may be ectopic or orthotopic. Treatment is difficult because it poses medical, ethical, and cosmetic aspects. A combined multidisciplinary team is required for the management and long term follow up is required. Excision or reconstruction of the duplicate penis is required depending on the corporal development and anatomy of the urethra.