2017 Volume 53 Issue 2 Pages 252-257
Purpose: Polyorchidism refers to the presence of more than two testes. It is a rare congenital anomaly. The aim of this study is to review the clinical picture and treatment of polyorchidism.
Methods: We retrospectively reviewed the cases of 5 children with polyorchidism, who visited Showa University Hospital and 3 affiliated hospitals during the last 5 years.
Results: All the patients were younger than 3 years. Polyorchidism occurred on the left side, and it was found during surgery for an undescended testicle. One patient had 3 left unilateral testes, 2 of which were supernumerary testes located in the abdominal position. The other patients had 2 left testes, located in the inguinal position. We performed orchiopexy on all the patients. During the postoperative period, 1 patient showed development of both testes. In 3 patients, 1 out of 2 testes atrophied. One patient required orchiectomy because of testicular atrophy.
Conclusions: Usually, a supernumerary testis is removed because of the risk for neoplastic transformation and sperm formation disorder. A review of 140 international cases of polyorchidism revealed that malignancy was found in only 5.7%, all of which were in cryptorchid supernumerary testes. Only 26% of the cases showed no spermatogenesis, but more than half had spermatogenesis ability. We propose that the pediatric cases of polyorchidism associated with the vas deferens should be managed by conservation therapy. The treatment of adult patients should be determined after biopsy.
