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[Triorchidism: which therapy?]

Eugenia Piro1, Laura Abati, Veronica Zocca

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Polyorchidism, having more than two testes, is rare. This case highlights successful preservation of a supernumerary testis in a 14-year-old boy with testicular torsion, demonstrating the importance of individualized management.

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Area of Science:

  • Reproductive medicine
  • Pediatric surgery
  • Urology

Background:

  • Polyorchidism is a rare congenital anomaly with more than two gonads, most commonly triorchidism.
  • Management of polyorchidism, particularly surgical intervention, remains controversial.
  • Testicular torsion is a surgical emergency requiring prompt diagnosis and treatment.

Observation:

  • A 14-year-old male presented with right-sided testicular torsion.
  • Intraoperative findings revealed a supernumerary testis anatomically continuous with the contralateral testis.
  • The supernumerary testis drained into the epididymis of the normal testis, forming a single deferent duct (Singer Type 1).

Findings:

  • Biopsies of both supernumerary and normal testes showed viable spermatogenic potential.
  • The supernumerary testis was preserved based on its anatomy and drainage pattern.
  • Post-preservation follow-up at 6 and 12 months revealed no pathological changes.

Implications:

  • This case supports the preservation of supernumerary testes in polyorchidism when anatomically favorable and possessing spermatogenic capacity.
  • Standardized diagnostic follow-up is crucial for preserved supernumerary testes.
  • Individualized management strategies are essential for polyorchidism, considering anatomical and functional characteristics.