The condition, known as Transverse Testicular Ectopia with Persistent Mullerian Duct Syndrome (PMDS), is an exceptionally uncommon congenital anomaly
Published Jul 11, 2025 | 9:26 AM ⚊ Updated Jul 11, 2025 | 9:26 AM
Both testes on one side: Rare surgery performed on 5-year-old at KIMS cuddles, Kurnool
Synopsis: In an extremely rare medical case, a five-year-old boy from Andhra Pradesh’s Kadapa district was diagnosed with Transverse Testicular Ectopia with Persistent Mullerian Duct Syndrome (PMDS)—a condition seen only once in a million
In a case that occurs only once in a million, a 5-year-old boy from the Kadapa district was found to have both testes on the same side of the scrotum. The rare condition, called Transverse Testicular Ectopia with Persistent Mullerian Duct Syndrome (PMDS), was successfully treated at KIMS Cuddles, Kurnool, by Paediatric and neonatal surgeon and Paediatric Urologist Dr. V. Sai Prasuna.
The child was rushed to the hospital after developing severe pain and swelling in the right testicle, which had turned red and uncomfortable. His parents, worried by the sudden pain, brought him to the emergency department at KIMS Cuddles.
“An ultrasound scan initially suggested obstructed inguinal hernia, where part of the intestine slips into the scrotum, causing pressure and inflammation of intestines,” said Dr. Sau Prasuna. During the physical examination, the doctors could not feel the left testis. When asked, the parents said both testes had earlier been seen in the scrotum. Based on that, the team assumed it might be a retractile testis, a condition where the testis moves up temporarily.
However, when surgery began to repair the hernia, the team made an unexpected discovery. “We found that both testes had descended through the hernia sac on the same (right) side,” said Dr. Sai Prasuna. On further inspection, doctors found that the spermatic cord with the vas deferens for both testes were fused together.
Adding to the complexity, “There were also underdeveloped female reproductive structures like a rudimentary uterus and fallopian tubes present between them,” she said. These structures were non-functional and would not cause any development of female characteristics.
The surgical team took extra care to manage the situation without damaging vital parts. “Despite the complexity, we carefully separated the testicles while preserving their blood vessels and vas deferens. We relocated the left testis to the left side of the scrotum transseptally through the right hemiscrotum and the right one to the right hemiscrotum ensuring both were in their correct anatomical positions,” explained Dr. Sai Prasuna.
Following surgery, the boy is recovering well and has been discharged. The future outlook is positive. “In the future, both testes are expected to function normally. Even if the relocated left testis fails to function due to the strain of repositioning, the right testis will be sufficient to produce sperm and support fertility,” said Dr. Sai Prasuna. She added that the underdeveloped female structures will not result in any female characteristics, as they are non-functional.
“This condition of PMDS is seen in one out of 4 million male births, with only about 300 cases reported worldwide to date. Often, it presents as an obstructed hernia and can be usually missed on ultrasound scans,” she said.
Dr. Sai Prasuna emphasised the need for timely expert care. “This case highlights the importance of expert evaluation and early intervention”, she added.
(Edited by Ananya Rao)
