Ectopic testis explained

Ectopic testis
Field:	Urology

Ectopic testis is used to describe the testis leaving the inguinal canal and entering a site other than the scrotum (ectopia). Usually, it results from obstruction of the scrotal entrance or from overdevelopment and lengthening of a segment of the gubernaculum.^[1]

The positions of the ectopic testis may be: in the lower part of the abdomen, front of thigh, femoral canal, skin of penis or behind the scrotum. The testis is usually developed, and accompanied by an indirect inguinal hernia. It may be divorced from the epididymis which may lie in the scrotum.^{[2] [3]}

Signs and symptoms

The ectopic testis can be in the perineal region, the opposite side of the scrotum, the suprapubic region, the femoral region, or in the superficial inguinal pouch.^[1]

The ectopic testis is initially normal, but if it is ignored after childhood, it may become small and soft, with spermatogenesis arresting and interstitial cell proliferation occurring.^[4]

Ectopic testes are prone to malignancy, epididymo-orchitis, infertility, testicular torsion, and trauma.^[5]

Causes

There is debate regarding the etiopathogenesis of ectopic testis.^[6] It could be caused by local mechanical barriers obstructing the normal descent, aberrant gubernacular stabilization as a result of an anomaly at its distal end, or aberrant interaction between androgen and calcitonin gene-related peptide (CGRP).^{[7] [8]}

Diagnosis

Diagnosis can be made based on the presence of an empty scrotum and swelling in the perineal area. Diagnosis can also be aided by palpation of the testis. Imaging methods like tomography and ultrasound might be necessary on occasion.^[9]

Treatment

The treatment of choice for ectopic testis is orchiopexy.^[9]

See also

• Cryptorchidism
• Orchiopexy

Further reading

• Gadelkareem . Rabea Ahmed . Shahat . Ahmed Abdelhamid . Reda . Ahmed . Moeen . Ahmed Mohamed . Abdelhafez . Mohamed Farouk . Abughanima . Mahmoud Farouk . Mansour . Osama . Mohammed . Nasreldin . Osman . Mahmoud Mohammed . Elderwy . Ahmed Abdelaziz . Hammouda . Hisham Mokhtar . Ectopic testis: an experience of a tertiary-level urology center at Upper Egypt . Annals of Pediatric Surgery . 16 . 1 . 2020 . 2090-5394 . 10.1186/s43159-020-00038-8 . free . none.
• KM . Backhouse . The natural history of testicular descent and maldescent . Proceedings of the Royal Society of Medicine . 1966 . Proc R Soc Med . 59 . 4 . 357–360 . 10.1177/003591576605900417 . 0035-9157 . 4380018 . 1900617 . none.
• Pugach . Jeff L . Steinhardt . George F . Evaluation and management of ectopic penile testis . Urology . Elsevier BV . 59 . 1 . 2002 . 0090-4295 . 10.1016/s0090-4295(01)01473-x . 137 . 11796301 . none.

Notes and References

1. Soomro . Sirajuddin . Mughal . Sikandar Ali . Perineal ectopic testis — a rare encounter in paediatric surgical practice . Journal of the College of Physicians and Surgeons--Pakistan . June 2008 . 18 . 6 . 386–387 . 18760056 . 5 January 2024.
2. Book: Roger . Stevenson . Judith . Hall . Human malformations and related anomalies . Oxford University Press . Oxford New York . 2006 . 0-19-516568-3 . 1272.
3. Web site: Ectopic testis. GP Notebook. 2011-12-15.
4. Middleton . George W. . Beamon . Charles R. . Gillenwater . Jay Y. . Two Rare Cases of Ectopic Testis . Journal of Urology . Ovid Technologies (Wolters Kluwer Health) . 115 . 4 . 1976 . 0022-5347 . 10.1016/s0022-5347(17)59241-1 . 455–458. 4633 .
5. Ramareddy . Raghu S. . Alladi . Anand . Siddappa . O.S. . Ectopic testis in children: Experience with seven cases . Journal of Pediatric Surgery . Elsevier BV . 48 . 3 . 2013 . 0022-3468 . 10.1016/j.jpedsurg.2012.10.005 . 538–541. 23480908 .
6. Nounla . J. . Tröbs . R.B. . Rolle . U. . Perineal Ectopic Testis: A Rare Cause of Empty Scrotum . Urologia Internationalis . S. Karger AG . 67 . 3 . 2001 . 0042-1138 . 10.1159/000050997 . 246–248. 11598455 . 23498735 .
7. HUTCHESON . JOEL C. . SNYDER . HOWARD M. . ZUÑIGA . ZACHARY V. . ZDERIC . STEPHEN A. . SCHULTZ . DELRAY J. . CANNING . DOUGLAS A. . HUFF . DALE S. . Ectopic and Undescended Testes: 2 Variants of a Single Congenital Anomaly? . Journal of Urology . Ovid Technologies (Wolters Kluwer Health) . 163 . 3 . 2000 . 0022-5347 . 10.1016/s0022-5347(05)67864-0 . 961–963. 10688032 .
8. Ku . Ja-Hyeon . Jeon . Youn-Soo . Lee . Nam-Kyu . Kim . Min-Eui . Park . Young-Ho . Two cases of perineal ectopic testis . International Journal of Urology . Wiley . 7 . 8 . 2000 . 0919-8172 . 10.1046/j.1442-2042.2000.00194.x . 307–309 . free. 10976819 .
9. Ulubay . Mahmut . Perineal ectopic testis: A rare congenital anomaly . Urology Case Reports . Elsevier BV . 24 . 2019 . 2214-4420 . 10.1016/j.eucr.2019.100853 . 100853 . free. 31211064 . 6562294 .