Three testicles in one hemiscrotum: an unusual presentation of polyorchidism

Abstract

Polyorchidism, or more than one testicle in a hemiscrotum, is a relatively rare phenomenon. It is often associated with several other conditions, including inguinal hernia, testicular maldescent, testicular torsion, hydrocele or hypospadias. In this report, we describe a patient who presented with three testicles in one hemiscrotum, which is a highly unusual presentation for an already uncommon condition. We also review the relevant literature as it relates to the need for surveillance due to the increased risk for malignancy.

Figure 1

Scrotal ultrasound showing normal right testicle and hypoplastic left testicle.

Figure 2

Distal testicle with epididymis at the inferior pole, but no lateral union of the testicle to the epididymis.

Figure 3

Distal testicle and more proximal, inner testicle contiguous with the same thick epididymis and ultimately the same vas deferens (not shown). These were both biopsy-proven testicular tissue.

Figure 4

A third testicle that was found while attempting to separate hernia sac from spermatic cord. This testicle was not in continuity with the epididymis or vas deferens.