Successful Preservation of Bilateral Undescended Testes with Hernioplasty in a 35-Year-Old Male: A Rare Surgical Triumph in Karnali Region

Background: Bilateral undescended testes (cryptorchidism) in adults is a rare condition and often associated with infertility and increased malignancy risk. Timely surgical intervention is vital for fertility preservation and oncological safety.  Case Presentation: A 35-year-old male presented to the surgical OPD of Karnali Academy of Health Sciences with groin swelling and dull pain. Imaging revealed bilateral intra-abdominal testes with associated hernia. Successful bilateral orchiopexy and hernioplasty were performed. Postoperative semen analysis was normal.  Conclusion: Timely surgical preservation of undescended testes even in adulthood can lead to favorable fertility outcomes. Long- term surveillance is recommended for malignancy risk.