The challenges of bilateral undescended testes among married adults in Port Harcourt, Nigeria: Case series and literature review

Abstract

Background: Bilateral undescended testis is rare in adult age, and increased risk of malignancy, torsion, and reduced fertility are known complications. This study reported cases of undescended testes and its attendant challenges among married adults. Materials and Methods: A case series was conducted among married adult patients who presented with undescended testes from 2014 to 2024, using patients’ records. Case Presentations: Case 1: 33-year-old married businessman with bilateral undescended testes and infertility, who solved his problem by consenting with the wife to have intercourse with other men, and had 2 children. Case 2: 40-year-old man with bilateral undescended testes presented with a 10-year history of infertility. The first wife had left after 3 years of marriage upon discovery of the source of the infertility, he subsequently had another partner and desired a solution to his infertility, but was lost to follow-up after counselling. Case 3: 24-year-old male student with bilateral undescended testes, who was aware of the risk of infertility during marriage, was counselled and had bilateral orchidopexy. Case 4: 56-year-old man with bilateral undescended testes presented at the Emergency Department with groin pain and swelling following malignant transformation of the left undescended testis. He was unaware of his lack of potential to conceive, but had 3 children with a “stable” home. Conclusion: Bilateral undescended testes in married adults is associated with considerable marital challenges. The scope of information disclosure during management is a moral burden that can be challenging for both the patients and the managing physicians.