Polyorchidism

　　The occurrence of polyorchidism may be due to the splitting of the epithelial cord in the early embryonic germ ridge during the process of differentiation into testicles due to some factors.. Polyorchidism generally rarely exceeds 3 testicles. In China, Zhao Guangmin and others reported a case of a patient with 4 testicular anomalies. In 1925, Holder reported a case with not only 5 testicles but also 3 scrotums, including 2 normal scrotums and testicles, 1 immature scrotum and testicle, and the extra testicles are often located on the left, which can present as an accessory located within the scrotum and requires histological examination to confirm. Meban reported 37 cases, 21 of which were on the left. Pelander and others analyzed 53 cases of polyorchidism, of which 15% of the ipsilateral testicles were cryptorchid. In the vast majority of cases, the extra testicles have descended, presenting as an asymptomatic mass within the scrotum..

　　Polyorchidism is a very rare congenital developmental abnormality, with most patients showing no symptoms and being discovered incidentally. Fertility is generally normal. However, timely treatment is required when complications such as testicular malignancy or torsion occur. In most cases, hernia or incomplete descent is also present. For patients who have developed a hernia, active surgical repair treatment should be performed.

　　Most patients with polyorchidism have no symptoms and are discovered accidentally. Fertility is generally normal. However, if the third testicle develops cancer or torsion, it needs to be treated promptly. In most cases, it is accompanied by hernia or incomplete descent. The third testicle with epididymis and vas deferens may also be a reason for maintaining fertility after vasectomy.

　　Patients with polyorchidism generally have no symptoms and are often diagnosed with hernia or additional testicular torsion, or palpable abnormal masses in the scrotum. Modern ultrasound and nuclear magnetic resonance diagnosis can be very clear, even without the need for exploratory surgery and pathological diagnosis.

　　The occurrence of polyorchidism may be caused by developmental abnormalities during embryogenesis, and there are no effective preventive measures. If the additional testicle develops normally without pathological changes, it may not need to be removed. Tumors and torsions require surgical removal, while in other cases, the testicles can be preserved but require routine checks, including ultrasound to rule out early tumors.

　　Polyorchidism should undergo ultrasound and pathological examination, as follows:

　　1. Ultrasound can check the location of polyorchidism, but the positive rate is usually low.

　　2. Exploration surgery can determine whether the scrotum or inguinal mass is a testicle, or when exploring for bilateral cryptorchidism, three or more testicles can be found in the abdominal cavity.

　　3. Histological examination of the mass requires histological confirmation.

　　Polyorchidism is a rare congenital developmental abnormality, and diet has no effective auxiliary treatment. The diet of most patients should be light and easy to digest, with an emphasis on eating more vegetables and fruits, and a reasonable diet should be followed, ensuring adequate nutrition. In addition, patients should avoid spicy, greasy, and cold foods.

　　The treatment of polyorchidism varies from person to person. Surgery is required to remove tumors and torsions, while in other cases, the testicles can be preserved but require routine checks, including ultrasound to rule out early tumors. If the additional testicle develops normally without pathological changes, it may not need to be removed.