Persistent Mullerian Duct Syndrome: A Rare Case of an Adult Infertile  Male with Bilateral Cryptorchidism

Prakash  Sankapal; Venkat Arjun Gite; Mayank  Agrawal; Mahesh  Sane; Atul   Singal

doi:10.18502/jri.v22i3.6722

Prakash Sankapal Department of Urology, Grant Government Medical College and Sir JJ Hospital, Mumbai, India
Venkat Arjun Gite Department of Urology, Grant Government Medical College and Sir JJ Hospital, Mumbai, India
Mayank Agrawal Department of Urology, Grant Government Medical College and Sir JJ Hospital, Mumbai, India
Mahesh Sane Department of Urology, Grant Government Medical College and Sir JJ Hospital, Mumbai, India
Atul Singal Department of Urology, Grant Government Medical College and Sir JJ Hospital, Mumbai, India

DOI: https://doi.org/10.18502/jri.v22i3.6722

Keywords: Anti Mullerian hormone (AMH), Cryptorchidism, Hysterectomy, Karyotyping, Mullerian in-hibiting substance (MIS), Orchidopexy, Persistent mullerian duct syndrome (PMDS), Primary infertility.

Abstract

Background: Persistent mullerian duct syndrome (PMDS) is a very rare form of internal male pseudohermaphroditism in individuals who are phenotypically males with 46 XY karyotypes harboring internal female reproductive organs which are Mullerian derivatives. It occurs as a defect in the genes coding for the Mullerian inhibiting substance (MIS) or the anti Mullerian hormone (AMH) receptor, ultimately leading to failure of regression of Mullerian ducts.

Case Presentation: A 29-year-old male with PMDS presented with complaints of primary infertility. Diagnosis was made with the help of high index of suspicion, radiological imaging, and karyotyping. Our patient underwent exploratory laparotomy with hysterectomy and bilateral orchidopexy.

Conclusion: The purpose of this study was increasing awareness regarding rare entities and surgeons should have high clinical suspicion of PMDS when patient with bilateral undescended testis comes for the evaluation of primary infertility.