Polyorchidism is an uncommon congenital anomaly which is characterized by presence of more than two testes. Therefore, we aimed to report a rare case of incidentally discovered polyorchidism during orchiopexy for left undescended testis.

An 11-month-old boy, presented with left empty hemiscrotum. He had no family history of any testicular anomalies. Physical examination showed normal right testis in the right hemiscrotum and non-palpable left testis with empty left hemiscrotum. Examination under anesthesia was then performed and the left testis was palpated at the neck of the left hemiscrotum. So, left standard scrotal orchiopexy was performed.

Scrotal exploration showed two viable left testes with one larger than the other. Both testes had two separate epididymides, but sharing a single vas deferens and the same gonadal vessels (Figure 1). The two left testes were brought down and fixed in the same subdartos pouch. The decision of preservation of the two testes was based on their accepted size, scrotal position and the young age of the patient. However, the parents were advised for routine follow-up by regular testicular examination and scrotal ultrasound. The patient was then discharged on the same day and was followed-up after one month with testicular examination and scrotal ultrasound, both showed viable two left testes.

The patient had two viable left testes. Both had two separate epididymides, but sharing a single vas deferens and the same gonadal vessels. Orchiopexy was done and the two left testes were fixed in the same subdartos pouch. The parents were then advised for routine follow-up by regular testicular examination and scrotal ultrasound. After one month, the patient showed viable two left testes by clinical examination and scrotal ultrasound.

Polyorchidism is a rare congenital testicular anomaly that should be expected during orchiopexy for undescended testis. Preservation of the supernumerary testes should be adopted in certain selected cases.