title: A novel approach in eight polyorchidism cases: vasoepidydimal or epididymo-epididymal approximation in single vas deferens duplicated testis.
abstract: OBJECTIVE
  To discuss the classification systems and pose a rationale for a flexible approach. We also propose our surgical approach for vasoepididymal or epidymo-epididymal approximation. Polyorchidism is a rare congenital anomaly with about 200 cases reported.
  
  
  METHODS
  We present 8 cases of polyorchidism treated at our institute from 1992 to 2010. To our knowledge, this is the most numerous single-center experience. We performed vasoepididymal or epidymo-epididymal approximation to restore near-normal anatomy plus stabilization of the testicular and ductal system to facilitate possible future reconstructive surgery.
  
  
  RESULTS
  In the case of contralateral anorchia or an atrophic testis, a supernumerary testis can fairly replace the contralateral counterpart. The reproductive potential of the supernumerary testis must not be ignored. Also, the malignant potential of the supernumerary testis should not be overestimated.
  
  
  CONCLUSIONS
  A careful pursuit of the vessel and vasal route during surgery for an undescended testis, judicious use of laparoscopy, and a lower threshold for diagnosis both on imaging studies and during surgery might result in a greater number of cases of polyorchidism in the daily practice of pediatric urology.
authors.affiliation: Children's Hospital Medical Center, Tehran University of Medical Sciences, Tehran, Iran. kajbafzd@sina.tums.ac.ir
authors.forename: Abdol-Mohammad
authors.initials: AM
authors.lastname: Kajbafzadeh
authors.forename: Seyyed Mohammad
authors.initials: SM
authors.lastname: Ghahestani
authors.forename: Mohammad Mahdi
authors.initials: MM
authors.lastname: Zamani
authors.forename: Majid
authors.initials: M
authors.lastname: Kajbafzadeh
authors.forename: Maryam Mohseni
authors.initials: MM
authors.lastname: Kia
mesh_terms: D001284:Atrophy; D004822:Epididymis / Q000601:surgery; D005832:Genital Diseases, Male / Q000601:surgery; D006801:Humans; D008297:Male; D013536:Suture Techniques; D013737:Testis / Q000002:abnormalities* / Q000473:pathology; D014564:Urogenital Abnormalities / Q000145:classification; D013521:Urologic Surgical Procedures, Male / Q000379:methods*; D014649:Vas Deferens / Q000002:abnormalities* / Q000601:surgery*