Polyorchidism: An Up-to-Date Systematic Review

Abstract

Polyorchidism is a rare male urogenital tract anomaly characterized by at least one supernumerary testis in the scrotum or ectopically. According to data based on our systematic review, 76% of the supernumerary testes (SNTs) were located in the scrotum, and 24% were extra-scrotal (p < 0.001). Among testes located outside the scrotum, 87% were found in the inguinal canal and 13% in the abdominal cavity. In 80% of cases, the diagnosis of SNT was made based on imaging tests, and the remaining 20% of cases were detected incidentally during surgery. The imaging tests performed (US or MRI) resulted in a significantly higher rate of patients who qualified for observation vs. surgical treatment (45% vs. 35%, p < 0.001). The most common conditions associated with SNT were ipsilateral inguinal hernia (15% of cases) and cryptorchidism (15% of cases). Surgery (orchidopexy/orchidectomy) was performed on 54% of patients with SNT, and the decision to observe the SNT was made in a total of 46% of patients (p = 0.001). The therapeutic approach depends on the location of the SNT and the presence of factors that raise suspicion of neoplastic proliferation.

Embryological basis of polyorchidism including classification, reproductive potential, and risk of malignancy: A review

“…However, further investigations are needed to clarify this matter and develop evidence-based recommendations (Balawender et al, 2021(Balawender et al, , 2023Virtanen & Toppari, 2015).…”

“…A scrotal SNT with high reproductive potential and no physical, radiological, or laboratory signs of malignancy should remain under ambulatory control. However, further investigations are needed to clarify this matter and develop evidence‐based recommendations (Balawender et al, 2021, 2023; Virtanen & Toppari, 2015).…”

“…Most cases are diagnosed among patients aged 15-25 years. Usually, polyorchidism is found incidentally during other surgical procedures or diagnostic imaging; in 80% of cases, SNT was diagnosed on the basis of imaging tests, and the remaining 20% were detected incidentally during surgery (Balawender et al, 2023). It is mainly asymptomatic, although it can sometimes manifest as inguinal pain or a palpable inguinoscrotal mass or swelling (Núñez García et al, 2021).…”

“…According to data based on the systematic review by Balawender et al, 76% of SNTs are located in the scrotum and 24% are extra‐scrotal. Among testes outside the scrotum, 87% are found in the inguinal canal and 13% in the abdominal cavity (Balawender et al, 2023; Kumar et al, 2008). The anomaly is generally limited to the left (65%) or the right (30%) side; however, it is bilateral in approximately 5% of cases.…”

“…Hydrocele of the testes is found in 7% of cases, and testicular torsion in 7%. In 4%, cancer is diagnosed in the SNT (Balawender et al, 2023). Most cases are diagnosed among patients aged 15–25 years.…”