Triorchidism; an incidental finding at inguinal hernia repair: A case report

INTRODUCTION: Polyorchidism is a rare congenital malformation with about 200 cases reported in literatures. Triorchidism and left side occurrence are the most common presentation. This case report was aimed to report the rare presentation of polyorchidism which was on the right side and along with incarcerated inguinal that make it by far the least encountered presentation. The intraoperative management for the polyorchidism was an issue of dilemma but adult type can be excised safely. PRESENTATION OF THE CASE: A 43 year old farmer presented with right side inguino-scrotal mass and recent failure to reduce to abdomen. He used to have pain lower abdominal pain with slight pressure since childhood but didn’t get any medical evaluation. He has completed his family number and didn’t complain any sexual problem. Physical examination showed that there was non-tender irreducible soft right side inguino-scrotal mass. The right side testis was not appreciated. DISCUSSION: Triorchidism is one of the commonly occurring variant of supernumerary testes that diagnosed incidentally during investigations or interventions for other pathologies. Incarcerated inguinal hernia masks its detection on physical examinations, so its diagnosis is more of intraoperative making a one time management for both pathologies at single operation especially if the operation undertake with general anesthesia. This patient was operated for incarcerated inguinal hernia with incidental finding of right side type B1 polyorchidism. Both of the right side testes were atrophic and excision was done. CONCLUSION: Patients who present at a late adulthood age with polyorchidism and undescended testis can be successfully treated with surgical removal of the atrophic supernumerary testes.