A rare anatomical variant: triple vas deferens encountered during varicocelectomy - a case report

The anatomical variations in the vas deferens are incidentally found during inguinoscrotal surgeries. These variations include agenesis, bifurcation, duplication, or triplication of the vas deferens due to embryological alteration. There have been many cases of duplication of the vas deferens and bifurcation of the vas deferens with polyorchidism reported in the literature. However, triplication of the vas deferens remains an extremely rare clinical entity, and only one case has been reported in the literature before this study.

A 29-year-old male with primary infertility was diagnosed with grade 4 varicoceles after clinical and radiological evaluation. He underwent bilateral microsurgical varicocelectomy. Intraoperatively, a rare triple vas deferens was found incidentally on the left. Recovery was smooth, and semen parameters improved significantly after 1 year.

Triple vas deferens is an extremely rare anomaly with only one prior case reported. Often diagnosed incidentally during surgery, preoperative detection remains challenging. Our case adds to the limited literature, emphasizing the need for awareness, improved diagnostic tools, and a registry to better understand and classify this condition.

Urologists should keep in mind the possibility of such variations during inguinoscrotal surgeries to avoid iatrogenic injury. Infertility patients should be evaluated for the possibility of encountering such abnormal variations during surgical management.