although several familial cases of tte have been reported , most of them were associated with persistent mllerian duct syndrome ( pmds ) . a 1-month - old boy was referred with a right hydrocele testis and a left nonpalpable testis . after a 7-month period of observation when the left testis was delivered through the internal inguinal ring , the right testis could not be palpated in the scrotum . subsequently , right inguinal exploration revealed that the testes were connected by a common vas deferens [ figure 1a ] . then , both testes were brought down through the right inguinal canal and each was placed on its respective side of the scrotum . inguinal exploration revealed two testes connected by a common vas deferens ( arrow ) in the older brother ( a ) and the younger brother ( b ) . each finding appears to be symmetrical an 8-month - old boy ( the younger brother of case 1 ) was referred with a left inguinal hernia and a right nonpalpable testis . this revealed that the right spermatic vessels and the vas deferens ran toward the left internal inguinal ring . subsequently , left inguinal exploration revealed that the testes were connected by a common vas deferens . the tunica albuginea of each testis was as rough as that of case 1 [ figure 1b ] . both testes were brought down through the left inguinal canal and each was placed on its respective side of the scrotum . a 1-month - old boy was referred with a right hydrocele testis and a left nonpalpable testis . after a 7-month period of observation when the left testis was delivered through the internal inguinal ring , the right testis could not be palpated in the scrotum . subsequently , right inguinal exploration revealed that the testes were connected by a common vas deferens [ figure 1a ] . then , both testes were brought down through the right inguinal canal and each was placed on its respective side of the scrotum . inguinal exploration revealed two testes connected by a common vas deferens ( arrow ) in the older brother ( a ) and the younger brother ( b ) . each finding appears to be symmetrical an 8-month - old boy ( the younger brother of case 1 ) was referred with a left inguinal hernia and a right nonpalpable testis . this revealed that the right spermatic vessels and the vas deferens ran toward the left internal inguinal ring . subsequently , left inguinal exploration revealed that the testes were connected by a common vas deferens . the tunica albuginea of each testis was as rough as that of case 1 [ figure 1b ] . both testes were brought down through the left inguinal canal and each was placed on its respective side of the scrotum . a 1-month - old boy was referred with a right hydrocele testis and a left nonpalpable testis . after a 7-month period of observation when the left testis was delivered through the internal inguinal ring , the right testis could not be palpated in the scrotum . subsequently , right inguinal exploration revealed that the testes were connected by a common vas deferens [ figure 1a ] . then , both testes were brought down through the right inguinal canal and each was placed on its respective side of the scrotum . inguinal exploration revealed two testes connected by a common vas deferens ( arrow ) in the older brother ( a ) and the younger brother ( b ) . an 8-month - old boy ( the younger brother of case 1 ) was referred with a left inguinal hernia and a right nonpalpable testis . this revealed that the right spermatic vessels and the vas deferens ran toward the left internal inguinal ring . subsequently , left inguinal exploration revealed that the testes were connected by a common vas deferens . the tunica albuginea of each testis was as rough as that of case 1 [ figure 1b ] . both testes were brought down through the left inguinal canal and each was placed on its respective side of the scrotum . fusion of the wolffian ducts is also considered a plausible mechanism for cases such as ours . the common vas deferens initially appeared to be a mllerian duct remnant , as shown in figure 1 . the cause of pmds is considered to be lack of mllerian - inhibiting substance ( mis ) synthesis or a defective mis receptor . the presence of the appendices testis indicates that the mis functioned well during the embryologic development . although some familial cases of tte have been reported , most of them were associated with pmds . pmds may be inherited as an autosomal - recessive or x - linked - recessive trait . wuerstle et al . reported two brothers among nonindentical triplets who had tte without mllerian duct remnant . our cases suggest that a genetic etiology is involved even in tte unrelated to pmds . the mode of inheritance is not clear in our cases because there was no family history of tte except for the affected brothers . orchiopexy could be performed without dividing the fused spermatic vessels and vasa deferense by this procedure . in conclusion , tte should be considered when an inguinal hernia and contralateral nonpalpable testis are present . a modified ombrdanne operation is useful for tte because it can avoid the injury of the spermatic vessels and vas deferens .
transverse testicular ectopia ( tte ) is rare . 
 although several familial cases of tte have been reported , most of them were associated with persistent mullerian duct syndrome ( pmds ) , which may be inherited as an autosomal - recessive or x - linked recessive trait . 
 we experienced two brothers with tte unrelated to pmds . 
 a genetic etiology may be involved even in tte unrelated to pmds .