Unusual Anatomy of the Testicular Arteries: A Case Report and Review of the Clinical Implications.

Testicular artery (previously known as internal spermatic artery or also known as gonadal artery) is an artery that branches from the anterolateral part of abdominal aorta at the level of the second lumbar vertebra and supplies the blood to the testes. Anatomical variations of the testicular vessels are not frequently reported in the literature. The available data demonstrates that there is an overall decrease in the number of cadaver studies published in the literature. The current case demonstrates a unique variation where the right testicular artery began as a common trunk with superior polar, inferior phrenic, capsular arteries and then had an unusual course covering the surface of the kidney. The left testicular artery, had a high origin from the aorta and also descended in an oblique course, covering the kidney. The current case is important because of its implications in renal transplantation, renal and adrenal surgery, vascular surgery, oncological surgery and other disciplines.

Five veins at the deep inguinal ring: can they reduce the chances of indirect inguinal hernia and increase the chances of varicocele? / Cinco venas en el anillo inguinal profundo. ¿pueden reducir las probabilidades de una hernia inguinal indirecta y aumentar las posibilidades de varicocele?

Complete duplication of testicular veins is a rare phenomenon. However, a few cases of duplication of gonadal veins have been reported. Here, I report a case of unusual formation and termination of the right testicular vein in an adult male cadaver. Five veins arose from the pampinniform plexus and entered the abdomen through the deep inguinal ring. The most medial among the five was large (3 mm in diameter) and it continued as a testicular vein and opened into the right edge of the inferior vena cava, 1 cm above the union of the common iliac veins. The other four veins were about 1 mm in diameter and they united to form two veins in front of the lower part of the right psoas and iliacus muscles (about 2 cm above the deep inguinal ring) and the two veins united to form upper testicular vein, 4 cm above the deep inguinal ring. This testicular vein was 3 mm in diameter and it opened into the inferior vena cava, 4 cm above the union of common iliac veins. Having five veins at deep inguinal ring might increase the chances of varicocele and decrease the chances of indirect inguinal hernia.

La duplicación completa de las venas testiculares es un fenómeno raro. Sin embargo, se han reportado algunos casos de duplicación de venas gonadales. En el presente trabajo se informa un caso de formación y terminación inusual de la vena testicular derecha en un cadáver de un hombre adulto. Cinco venas surgieron del plexo pampiniforme y penetraron en el abdomen a través del anillo inguinal profundo. El más medial entre los cinco fue de gran tamaño (3 mm de diámetro) y continuó como una vena testicular y se abrió hacia el margen derecho de la vena cava inferior, 1 cm por encima de la unión de las venas ilíacas comunes. Las cuatro venas restantes eran de 1 mm de diámetro aproximadamente, y se unieron para formar dos venas frente a la parte inferior de los músculos psoas e ilíaco derechos (aproximadamente 2 cm por encima del anillo inguinal profundo). Se unieron dos venas para formar la vena testicular superior, la cual medía 3 mm de diámetro y se abría hacia la vena cava inferior, 4 cm por encima de la unión de las venas ilíacas comunes. Cinco venas en el anillo inguinal profundo podrían aumentar las posibilidades de varicocele y disminuir las posibilidades de una hernia inguinal indirecta.

Anatomical Variation Of Testicular Veins And Its Embryological Importance

Introduction: Normally testes are drained by testicular veins. About 15 – 20 veins appear on the posterior borderof testes and epididymis which unite to form the pampiniform plexus. Right testicular vein drains directly intoinferior vena cava whereas left testicular vein drains into left renal vein [1]. These veins have much variationwhich includes in number, course & termination.Aim: To study the anatomical variation in termination of testicular veins.Materials and Method: Study was conducted in 30 cadavers by regular dissection to analyze the variation innumber and termination.Result: In the present study, testicular vein was normal in number and termination in 26(86%) cases. In remainingcases, variation was observed in the form of duplication of testicular vein in 1(3.33%) of the cadavers andvariation in termination was seen in 3(6.67%) of the cadavers.Conclusion: Awareness about these variations will be helpful during surgical procedures.

Terminal bifurcation and unusual communication of left testicular vein with the left suprarenal vein / Bifurcação terminal e comunicação atípica de veia testicular esquerda com veia suprarrenal esquerda

Abstract Variations of the testicular veins are relevant in clinical cases of varicocele and in other therapeutic and diagnostic procedures. We report herein on a unique variation of the left testicular vein observed in an adult male cadaver. The left testicular vein bifurcated to give rise to left and right branches which terminated by joining the left renal vein. There was also an oblique communication between the two branches of the left testicular vein. A slender communicating vein arose from the left branch of the left testicular vein and ascended upwards in front of the left renal vein and terminated into the left suprarenal vein. The right branch of the testicular vein received an unnamed adipose tributary from the side of the abdominal aorta. Awareness of these venous anomalies can help surgeons accurately ligate abnormal venous communications and avoid iatrogenic injuries and it is important for proper surgical management.

Resumo Variações nas veias testiculares têm relevância em casos clínicos de varicocele e em outros procedimentos terapêuticos e diagnósticos. Relatamos aqui uma variação peculiar de veia testicular esquerda observada em um cadáver adulto do sexo masculino. A veia testicular esquerda bifurcava para dar origem aos ramos esquerdo e direito, os quais terminavam juntando-se à veia renal esquerda. Foi observada também comunicação oblíqua entre os dois ramos da veia testicular esquerda. Uma fina veia comunicante originava-se do ramo esquerdo da veia testicular esquerda e ascendia até a frente da veia renal esquerda, terminando na veia suprarrenal esquerda. O ramo direito da veia testicular recebia um tecido adiposo tributário não especificado da lateral da aorta abdominal. Conhecimento dessas anomalias venosas pode ajudar os cirurgiões a ligar corretamente comunicações venosas anormais e evitar danos iatrogênicos e é importante para um manejo cirúrgico apropriado.

Variaciones anatómicas bilaterales de vasos renales y testiculares / Bilateral anatomical variations of renal and testicular vessels

Normalmente las arterias testiculares surgen de la aorta abdominal, aunque hay reportes acerca de variaciones en su origen. También es un hallazgo común dos arterias renales (derecha e izquierda) derivadas de la aorta abdominal que suministran irrigación al respectivo riñón de cada lado, y actualmente la literatura reporta gran variabilidad en el número de arterias renales. Durante una disección de rutina en un cadáver masculino de 65 años de edad se encontraron múltiples variaciones anatómicas bilaterales de vasos testiculares y renales. Las variaciones encontradas fueron: presencia bilateral de tres arterias renales y tres venas renales, vena renal izquierda retro-aórtica, terminación de la vena frénica inferior izquierda en la vena renal izquierda, doble arteria testicular izquierda y doble arteria testicular derecha, todas originándose desde arterias renales accesorias. Las variaciones descritas aquí son únicas, no conocidas, ya que es el primer caso reportado hasta ahora en la literatura disponible y proporcionan una información significativa a radiólogos, endocrinólogos, especialistas en fertilidad, urólogos y cirujanos, en la determinación de la viabilidad de intervenciones quirúrgicas libres de complicación en esta región, así como el manejo postoperatorio.

Testicular arteries normally arise from the abdominal aorta. There are reports about of variations in the origin. It is also a common finding two (right and left) derived renal arteries of the abdominal aorta to the respective supplying irrigation kidney from each side, current literature report great variability in the number of renal arteries. Multiple anatomical variations bilateral of testicular vessels and renal were found during routine dissection in a 65-year-old male cadaver. The variations found were: bilateral presence of three renal arteries and three renal veins, left renal vein retro-aortic, termination of the left inferior phrenic vein into the left renal vein, double left testicular artery and double right testicular artery all originating from accessory renal arteries. The variations described here are unique is not known since it is the first case reported so far in the available literature and provide significant informations to radiologists, endocrinologists, fertility specialists, urologists and surgeons, in determining the feasibility of complication-free surgical interventions in this region as well as the post-operative management.

Variation in the Origin of the Testicular Arteries and Drainage of the Right Testicular Vein / Variación en el Origen de las Arterias Testiculares y el Drenaje de la Vena Testicular Derecha

During routine dissection of a 42 year old male Indian cadaver posterior abdominal wall, variations in the testicular vessels were observed. The right testicular artery arose from the right accessory renal artery, which originated from the ventral aspect of the abdominal aorta. The left testicular artery originated from the ventral aspect of the aorta in almost the same horizontal line as the right accessory renal artery, just below the superior mesenteric artery and 1.79 cm, above the origin of the renal arteries. The right vein drained into the right accessory renal vein instead of the inferior vena cava, while the left testicular vein drained into the left renal vein. The presence of variation of both the testicular arteries as well as the testicular vein is seldom seen together.

Durante una disección de rutina de un cadáver, perteneciente a un hombre indio de 42 años, se observaron variaciones en los vasos testiculares en la pared abdominal posterior. La arteria testicular derecha se originó desde la arteria renal accesoria, proveniente de la cara ventral de la parte abdominal de la aorta. La arteria testicular izquierda se originó en la cara ventral de la parte abdominal de la aorta, casi en la misma línea horizontal de la arteria renal accesoria derecha, justo distal a la arteria mesentérica superior y 1,79 cm sobre el origen de las arterias renales. La vena renal derecha drenaba en la vena renal accesoria en lugar de la vena cava inferior, mientras que la vena testicular izquierda drenaba en la vena renal izquierda. En muy pocas ocasiones es posible observar de manera conjunta, variaciones tanto de las arterias como de las venas testiculares.