Incidental discovery of persistent Müllerian duct syndrome with transverse testicular ectopia during adult inguinal hernia repair: A case report.

Transverse testicular ectopia (TTE) associated with persistent Müllerian duct syndrome (PMDS) is a rare congenital anomaly that may remain undiagnosed until adulthood. We report a 27-year-old man with a right inguinal hernia, non-palpable left testis, and primary infertility. During hernia repair, exploration revealed a uterus, bilateral fallopian tubes, and an atrophic ectopic left testis within the right inguinal canal. Müllerian structures were excised, left orchidectomy performed, and the right testis preserved by orchidopexy. Histopathology showed no malignancy. Postoperative evaluation demonstrated a normal 46,XY karyotype and azoospermia. This case highlights the challenges of adult TTE with PMDS.