Abstract
BACKGROUND: Transverse testicular ectopia (TTE) is a rare congenital anomaly where both testes descend through the same inguinal canal and are located on the same side. Cases with fused spermatic cords are particularly rare and present unique surgical challenges. CASE DESCRIPTION: We report the case of an 8-month-old male infant with bilateral cryptorchidism and an empty scrotum since birth. Preoperative ultrasonography identified two testicular-like structures near the right internal inguinal ring. Laparoscopic exploration revealed bilateral patent processus vaginalis, with both testes located near the right internal inguinal ring. The left spermatic cord crossed the pelvis and fused with the right spermatic cord. Both testes appeared normal in size, with separate epididymides and vas deferens. Surgical management involved careful dissection and separation of the fused spermatic cords, followed by bilateral orchiopexy via the respective inguinal canals and repair of the processus vaginalis. At an 8-year postoperative follow-up, ultrasound confirmed that both testes were well-positioned with normal size and blood supply. Testosterone levels were monitored annually and remained within the normal range. This case highlights its significant role in the management of complex anomalies like TTE. CONCLUSIONS: The postoperative course was uneventful, and an 8-year follow-up demonstrated that both testes remained well-positioned, with normal size, blood supply, and testosterone levels.