Coexistence of Scrotoschisis and transverse testicular ectopia: An exceptionally rare disorder in a newborn

Abstract

Scrotoschisis with transverse testicular ectopia is a rare congenital disorder affecting male external genitalia, characterized by the extrusion of one or both testes through a defect in the scrotal wall and the abnormal descent of both testes into one hemiscrotum. This case report details a twelve-hour-old male newborn referred to Muhimbili National Hospital in Tanzania, presenting with both conditions. The infant was delivered via Cesarean section due to obstructed labor, with a birth weight of 3 kg and an Apgar score of 9 and 10 at 1 and 5 minutes, respectively. Upon examination, both testes were found extruded through a defect in the right hemi-scrotum, with the left spermatic cord crossing over to the right side. Preoperative abdominal pelvic ultrasound revealed no abnormalities. The infant was stabilized with intravenous antibiotics and analgesics. Surgical intervention involved scrotal exploration under general anesthesia, where adhesions were released, and the left testis was transposed to the left hemi-scrotum. Bilateral orchidopexy was performed, and the scrotal wall was repaired in layers. The child was discharged on postoperative day seven with significant improvement. This case highlights the coexistence of Scrotoschisis and transverse testicular ectopia, which poses unique challenges in diagnosis and management. While the exact etiology remains unclear, various theories have been proposed. This report emphasizes the importance of timely surgical intervention and the need for further research into the pathogenesis of these rare conditions.