Men with no testicles, one testicle or two are nothing out of the ordinary, but men with three are rare. A story is told of a monk who was unable to keep his vow of chastity because of having three testicles, while an eighteenth-century account describes a man with multiple testicles, a condition known medically as polyorchidy, who was capable of sexual intercourse up to his hundred and twenty-fifth year. Others were reputedly capable of ejaculating twenty times in one night. Ambrosius Pare, one of the giants of medical history, believed that extra testicles were a common phenomenon, and many surgeons shared his view. Undoubtedly these were almost always spermatoceles that were mistaken for additional testicles.
In a medical career of nearly thirty years I have only ever encountered one case of multiple testicles. The boy in question had three — a case of triorchidy, which can take various forms. There may be an extra testicle without an epididymis or seminal duct (a), an extra testicle with an epididymis but without a seminal duct (b), an extra testicle with an epididymis attached to the seminal duct of a testicle located below (c),
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and an extra testicle with an epididymis and an extra seminal duct. These are different kinds of tissue faults between the sixth and eighth week in the development of the embryo, the period during which it is decided whether one is going to look like a girl or a boy as regards external sexual characteristics.
Most patients with polyorchidy present with a painless swelling. The most common location for the abnormality is on the left. In most men the diagnosis is made between the ages of fifteen and 25, and in 80 per cent of cases tissue examination of removed additional testicles showed a reduced or non-existent production of sperm cells. M. Hakami and S. H. Mosavy described a man with fertile sperm in whom the third testicle was discovered only after a vasectomy on both sides.