Polyorchidism – The Multiple Testes Syndrome

Polyorchidism is when there are more than two testes. This is extremely rare, and is a congenital disorder, meaning it has been present since birth. There are fewer than 200 cases of this disorder that have been documented. The condition is usually asymptomatic (no symptoms). The extra testis is usually found in the left sac of the scrotum. Sometimes it shares an epididymis and vas deferens and sometimes it will have its own epididymis and share a vas deferens with the other testes. This may be the cause of men who have had a vasectomy still remaining fertile, although this is rare. The epididymis is the coiled tube behind the testicle that stores and carries the seminal fluid. The vas deferens is the main duct that carries semen to the ejaculatory duct, and it is connected to the epididymis.

Polyorchidism Diagnosis and Study

Polyorchidism is usually discovered when having an ultrasound for inguinal hernia or testes that have not yet descended. The average age of detection is when the male is about 18 years of age. Surgery is usually carried out if the extra testis is suspected of being malignant (cancerous). A man with extra testes is medically defined as a Polyorchid. The most usual form of polyorchidism is triorchidism, where there are three testes. Sonoraphy and magnetic resonance imaging (MRI) have greatly aided in the diagnosis of polyorchidism, especially in recent years due to greatly improved and more accurate equipment.

While tumors and torsions (twisting of the cords and veins leading to the testicle) will require surgery, the extra testicle may be left in place and as long as it is monitored on a regular interval including sonography. These decisions will be made by the doctors on a case by case basis. In medical literature polyorchidism was first documented in the 1880’s. Long ago in history there have been several cases reported anecdotally about people with extra testes. A Venetian admiral named Bartolomeo Colleoni (1400-1475), was said to have a supernumerary or extra testicle, he became quite famous. In the Italian language ‘colleoni’ means testicle and is now spelt ‘coglioni’. Also, Philipp, Count of Hesse (1504-1567) was given permission in 1539 to take another wife by Martin Luther, because he had a supernumerary testicle.

It is the thought of the medical fraternity that polyorchidism is a result of doubling over of the genital ridge early in the embryonic stage of development, at about four to six weeks. This doubling or duplication does not only relate to the testes, but can also lead to doubling of the epididymis and or vas deferens. But in reality, it is not really known what causes polyorchidism, but at the time of writing it is thought to be the doubling over of the genital ridge.

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