SOC
Surgery on Children

Surgery on Children Journal aims to publish issues related to Pediatric Surgery, Pediatric Neurosurgery, Pediatric Plastic Surgery, Pediatric Cardiovascular Surgery, Pediatric Orthopedic Surgery, Pediatric Vascular Surgery, Pediatric Gynecology and Obstetrics, Pediatric Ear Nose Throat, Ophthalmology, Pediatric Anesthesiology and Reanimation, Pediatric Urology, Pediatric Surgical Intensive Care Clinic, and other clinical surgery fields on children of the highest scientific and clinical value at an international level and accepts articles on these topics.

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Pediatric supernumerary testis: preservation, orchiopexy, or orchiectomy?
Abstract
Polyorchidism is a rare congenital anomaly in which more than two testes are present. In children, its importance lies less in rarity than in the surgical dilemma created when an additional gonad is identified during examination, imaging, or surgery for cryptorchidism, hernia, torsion, or an inguinoscrotal mass. To review the contemporary evidence on pediatric supernumerary testes and to provide a practical framework for deciding when a viable gonad should be preserved, fixed, or removed. A focused narrative review was undertaken using key historical publications, systematic reviews, contemporary pediatric pooled analyses, and selected case reports relevant to embryology, classification, imaging, diagnostic pitfalls, torsion, malignancy, reproductive potential, and surgical management. Current evidence favors preservation of a viable, morphologically reassuring supernumerary testis when surveillance is feasible. Orchiopexy is appropriate when a viable gonad is malpositioned or has a demonstrable fixation abnormality. Orchiectomy remains appropriate for irreversible ischemia, severe atrophy or involution, grossly abnormal tissue, or genuine oncological suspicion. The absolute malignant risk of a normal pediatric supernumerary testis remains uncertain and should not be inferred directly from historical case-report series. Management should be individualized according to viability, morphology, position, vascular and ductal anatomy, associated cryptorchidism, torsion risk, oncological concern, and feasibility of follow-up. The presence of a supernumerary testis alone is not an indication for orchiectomy.

Keywords : Cryptorchidism, orchiopexy, orchiectomy, testicular torsion, ultrasonography

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Author Contributions

Conceptualization: NB; Design: NB, FF; Supervision: NB; Literature Assessment: NB, FF; Analysis and/or Interpretation: NB, FF, AT, MEB; Literature Review: NB, FF, AT, MEB; Writing: NB, FF, AT, MEB; Critical Review: NB, FF, AT, MEB; Final Approval: All Authors; Accountability: All Authors.

Conflict of Interest

The authors declare no conflicts of interest.

Financial Disclosure

No financial support was received for the preparation or publication of this article.


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Article available in :
Volume 3, Issue 4, 2026
Page : 155-160
https://doi.org/10.51271/SOC-0089
Article Information
Received : 23 Ağu 2026
Accepted : 29 Eyl 2026
Published : 20 Eki 2026
Corresponding Author :

Nikolaos Baltogiannis: Department of Pediatric Surgery , Children's Hospital of Athens Medical Group, Athens, Greece

[email protected]
Citation : Baltogiannis N, Fili F, Tsangos A, Baltogianni ME. Pediatric supernumerary testis: preservation, orchiopexy, or orchiectomy? A contemporary review of diagnosis and surgical decision-making. Surg Child. 2026;3(4):155-160. doi:10.51271/SOC-0089

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