Penile testis ectopia: a rare urogenital condition

Description

Ectopic testis is thought to result from an abnormality of terminal testicular descent in which the testis initially descends normally through the external inguinal ring but then, due to some mechanical failure, comes to rest at a location outside the normal pathway of descent.^{1 2} Although several theories support that ectopia relates to some gubernaculum development abnormality, there are still no proven studies that identify the biochemical cause of it.¹

An ectopic testis may be located in the superficial inguinal pouch of Denis Browne, perineum and penis or lateral to the scrotum, pubic region, thigh or contralateral scrotum.¹

A 14- year-old boy from Sao Tome e Principe presented in the urology department, visiting for a congenital penile mass that grew in the last year. There was no pain associated. On genital physical examination, there were signs of puberty and an oval mass was seen in the dorsal surface of the penile shaft. The right hemiscrotum had no testicle (figure 1).

Figure 1.

Preoperative evaluation.

It was assumed a right testis ectopia in penile shaft and was proposed to carry out a surgical reconstruction to replace the penile right testis in the hemiscrotum. An inguinal right incision was performed (figure 2) to expose the cord and orquidopexia (figure 3).

Figure 2.

Inguinal exploration and cord exposition to evaluate its length.

Figure 3.

Final observation after orchidopexy in the homolateral scrotum.

This is a rare case with only a few cases reported in the literature. All the reports declare the same surgical approach so that it can evaluate the absence of hernia and, after mobilisation of the testis and its cord, replacement to the correspondent scrotal side.^{1 2}

Learning points.

• Penile testicular ectopia is a rare genital malformation associated with a change in the implementation of the gubernaculum after the passage in the inguinal canal.

• The surgical inguinal resolution allows the preservation of the testicle with good aesthetic results.