PMC8519711_01
Patient in standing and lying positions showing hypoplasia of right hemiscrotum and left suprascrotal bulge.
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fig1
On examination, there was a vacant, hypoplastic right hemiscrotum with no palpable right testis along its normal course; a normal looking left hemiscrotum containing a testis; an ovoid shaped mass at the left suprascrotal area which was firm, nontender and not fixed to the deep or superficial plane (Figures 1 and 2).
Examiner isolating two separate masses on the left path of testicular descent.
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fig2
On examination, there was a vacant, hypoplastic right hemiscrotum with no palpable right testis along its normal course; a normal looking left hemiscrotum containing a testis; an ovoid shaped mass at the left suprascrotal area which was firm, nontender and not fixed to the deep or superficial plane (Figures 1 and 2).
Laparoscopic view of the spermatic vessels (blue arrow) and vas deferens (yellow arrow) exiting the right "open" deep inguinal ring (red arrow).
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fig3
On laparoscopic evaluation under general anesthesia, the right spermatic vessels and vas were seen going through an open right deep inguinal ring (Figure 3).
Laparoscopic view of the spermatic vessels (blue arrow) and vas deferens (yellow arrow) exiting the left "closed" deep inguinal ring (red arrow).
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fig4
The spermatic vessels and vas on the left were seen traversing their corresponding closed deep inguinal ring (Figure 4).
(a) Left and right testes shown through a median raphe scrototomy looking macroscopically normal. (b) No fusion of vessels nor vasa, nor epididymotesticular separation.
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fig5
Both testis appeared macroscopically normal with no epididymotesticular fusion anomaly and unfused vasa deferentia (Figure 5).
(a) Right inguinal dissection. (b) Closure of a right patent processus vaginalis.
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Transseptal orchidopexy was undertaken for the right testis with its longer cord length (Figure 6), and an ipsilateral orchidopexy was done for the nondescended suprascrotal left testis (Figure 7).
Transseptal orchidopexy of the right testis and closure of the scrotal septum.
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fig7
Transseptal orchidopexy was undertaken for the right testis with its longer cord length (Figure 6), and an ipsilateral orchidopexy was done for the nondescended suprascrotal left testis (Figure 7).
Final aspect after bilateral orchidopexy and routine circumcision.
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The early postoperative period was uneventful with mild tenderness on palpation and a full-looking scrotum (Figures 8 and 9).
Scrotal aspect on day 5 postoperative.
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fig9
The early postoperative period was uneventful with mild tenderness on palpation and a full-looking scrotum (Figures 8 and 9).