Boy, two, born without an anus and half his scrotum buried in his groin has surgery 

Boy, two, born with half his scrotum buried in his GROIN and missing an anus has life-changing surgery to fix his rare defect

  • The unnamed toddler was born with the left ‘half’ of his scrotum in his groin
  • Doctors first made an anus by creating an opening in his sphincter muscles
  • They later moved half of his scrotum and his undescended testicle down 

A two-year-old who was born with a separated scrotum and no anus has had life-changing surgery.

The unnamed toddler had an ectopic scrotum, which caused the left ‘half’ to be buried in his groin, while the testicle was descended in his abdomen.

The right side of his scrotum was in its correct place, complete with a testicle.

The youngster, from Indonesia, was also missing an anus. Doctors set about treating this first by creating an opening in his sphincter muscles.

In a later operation, they moved the left side of his scrotum to the correct position, followed by his testicle. The two halves of the sac were then ‘fixed’. 

The ‘relatively simple’ procedure had a ‘favourable cosmetic result’. The boy is thought to be doing well.

A two-year-old born with a 'split' scrotum and no anus has had life-changing surgery (stock) A two-year-old born with a 'split' scrotum and no anus has had life-changing surgery (stock)

A two-year-old born with a ‘split’ scrotum and no anus has had life-changing surgery (stock)

The boy had surgery to create an anus, known as posterior sagittal anorectoplasty, at the University of Indonesia’s faculty of medicine. 

The procedure took place in June 2016. Prior to the surgery, most patients have their waste collected in a stoma bag. 

He also had spina bifida – a fault in the development of the spine. Surgeons operated on this defect in February the following year.   

During ‘clinical examination’, doctors noted the ‘right’ side of his scrotum, complete with a testicle, was in the correct place.

However, the left half of his scrotum was in his groin, with its corresponding testicle in the abdomen. His penis had developed as normal.

WHAT IS AN ECTOPIC SCROTUM? 

A scrotum is ectopic if it is found in an abnormal part of the body, usually the abdomen or groin.

Cases are ‘rare’, the exact prevalence is unknown.  

Patients also often suffer hernias, undescended testicles and bladder defects.

Ectopic scrotums are thought to come about due to defects in the development of the gubernaculum.

During week 12 of pregnancy, the gubernaculum, a ‘cord’, ‘guides’ the testicles into the scrotum.

Treatment is surgical, with the scrotum and testicle being moved into the correct place. 

Doctors conducted an X-ray of his pelvis which revealed some of his pubic bones were separated – they are supposed to be joined. 

Writing in the journal Urology Case Reports, the doctors said they decided not to treat this due to the ‘risk of surgery outweighing the benefits’. 

They did, however, surgically correct the misplaced half of his scrotum, along with its testicle.  

Scrotum abnormalities are rare, the team wrote. The scrotum starts developing four weeks after conception.

In week 12, ‘scrotal swellings’ start to move together and fuse, forming the sac.

An embryonic ‘cord’ called the gubernaculum guides the testicles to descend into the scrotum.

Defects in the gubernaculum can impair or prevent scrotal swelling movement and fusion. 

These can come about due to ‘mechanical’ issues, such as if the baby is breech or suffering from oligohydramnios, a lack of amniotic fluid. 

Genetic or chromosomal issues may also be to blame, as well as radiation, maternal infections, exposure to chemicals and certain drugs. 

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