Triorchidism: Presenting as Undescended Testis in a Case of Indirect Inguinal Hernia

Abstract

Triorchidism is the commonest variety of polyorchidism, an entity with more than two testis is an extremely rare congenital anomaly of the testis. Although excision of the abnormal testis is a safer alternative proposed, recent literature suggests more conservative approach in normal testes with watchful regular follow up to screen for malignancy. This case presented as a left inguinal swelling diagnosed as indirect left inguinal hernia. The left side testis was of smaller size (about half) with normal sperm count, morphology and motility. Intraoperatively indirect inguinal hernia was noted with supernumerary testis at deep ring in addition to normal left testis in left scrotal sac. The ectopic testis were small (2.5×2.5×1 cm) lacking epididymis and with short vas deferens. An evident normal semen analysis and varied anatomy, the decision for orchidectomy of ectopic testis was taken. The histopathological finding was consistent with arrest in germ cell development.

A Child with 3 Testes: Polyorchism

“…[4,5] As per anatomical location, intra scrotal variety is most prevalent, followed by inguinal and sometimes intra-abdominal testicles. Commonly they are associated with indirect inguinal hernia.…”

Difficulties in Diagnosing Extraperitoneal Ureteroinguinal Hernias: A Review of the Literature and Clinical Experience of a Rare Encounter in Acute Surgical Care Settings

“…Inguinal hernias are classified as direct and indirect based on the relationship of the herniation sac with the inguinal canal [ 1 ], while both types can involve structures from the intraperitoneal or extraperitoneal space [ 2 ]. A direct hernia is formed when the hernia sac protrudes directly through the posterior wall of the inguinal canal [ 3 , 4 ], while in the indirect type, the sac follows the inguinal canal in conjunction with the spermatic cord after entering through the internal inguinal ring [ 5 , 6 ]. The prevalence of inguinal hernias accounts for 1.7% of the general population, with an increasing 4% in people older than 45 [ 7 ].…”