Variations of testicular vessels are more common than supposed. The testicular artery varies because of abnormal regression of the lateral mesonephric arteries in the fetus, whereas variations in the testicular vein are due to abnormalities in the involution of the intersubcardinal anastomosis. Such variations are usually found incidentally during surgical procedures around the renal pedicle and they often lead to complications. Several authors have attempted to classify them. However, these attempts have not been comprehensive. Therefore, the aim of this study is to provide a simple yet comprehensive classification of variations of the testicular vessels. The PubMed database was searched using keywords pertaining to the testicular vessels. The results were subjected to the Anatomical Quality Assessment (AQUA) tool analysis and were screened for appropriateness for inclusion in this study. The screening procedure yielded 31 original articles, 83 case reports, and 1 review article. Both testicular arterial and venous variations were more common on the left side (20.73% and 24.61%) than the right (12.69% and 18.4%, respectively). We classified the testicular arteries on the basis of their number (N), site of origin (O), and course (C). Similarly, the testicular veins were classified on the basis of their number (N) and site of drainage (D). The proposed classification facilitates identification, understanding, and reporting of variations of the testicular vessels by radiologists. It will also help surgeons to enhance the quality of their treatment. Clin. Anat. 31:854-869, 2018. © 2018 Wiley Periodicals, Inc.
Introduction: Introduction The testicular arteries are liable to get injured during interventions around the renal pedicle. The present study aimed to record the anatomical variations in testicular arteries to assist surgeons and radiologists in avoiding unforeseen complications. Materials and Methods: a total of 25 formalin-embalmed adult cadavers were dissected, and the number, origin, relationships with the inferior vena cava and renal veins of the testicular arteries were recorded. The distance between the origins of the renal and testicular arteries from the abdominal aorta was measured, and the results were statistically analyzed. Results: out of 50 cadaveric sides, variations were observed in 14%. The most commonly observed variation was an arched testicular artery (10%). Double testicular arteries were observed in 4% of the sample, and testicular arteries with renal origin were observed in 6%. Most variations were right-sided (71.4%). The testicular artery originated at the second lumbar vertebral level in 94.2% of the sample. The mean distance between the origins of the testicular and renal arteries was 3.60 0.36 cm on the right, and 2.28 ± 0.92 cm on the left, and the difference between the two sides was statistically significant. Conclusion: the left testicular artery is closer to the renal pedicle, and is more likely to be at risk during surgeries in the hilar area. Cases with renal origin and arching of the testicular artery are also at a high risk. Compression of the testicular artery due to arching or retrocaval course could be a causative factor for the development of varicocele. The presence of such variations should be meticulously assessed using radiological imaging prior to interventions.
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