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  • Title: Triorchidism with normal spermatogenesis: an unusual cause for failure of vasectomy.
    Author: Hakami M, Mosavy SH.
    Journal: Br J Surg; 1975 Aug; 62(8):633. PubMed ID: 1174804.
    Abstract:
    The wife of a vasectomized man became pregnant by her husband. He was examined and a supernumerary testis with intact vas and with normal histology and normal spermatogenesis were discovered. Triorchidism, a rare anatomical phenomenon has been reported in 24 cases and in only 6 has spermatogenesis occurred. One of these 6 is a 45 year old man who had been bilaterly vasectomized without semen analysis following surgery. The patient's wife, complaining of 4 months amenorrhea, was thought to be pregnant. Examination of the patient revealed 2 lumps detected in the right hemi-scrotum which felt like small testes and did not permit transillumination. The left testis was normal and laboratory tests including excretory urography were normal. Semen analysis revealed normal spermatogenesis. At operation under local anesthesia, 2 vasa deferentia were detected in the right scrotum one of which had been partly resected. At no point did the 2 structures communicate. Resection of the supernumerary vas deferens was completed and biopsies of both right hemiscrotal testes proved normal. Moreover, the testis with intact vas deferens showed normal spermatogenesis. In the left scrotum a second resection was performed on the upper end because it had been only partly resected. Histological examination of the resected vasa deferentia confirmed triorchidism with normal spermatogenesis. This condition may be associated with other congenital abnormalities such as anomalous union between the testis and its epididymis, absence of a rete testis and hernia and hydrocele. Urogenital examinations before vasectomy and post vasectomy semen analyses should be done to prevent similar occurrences.
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