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Youm J, Choi MJ, Kim BM, Seo Y. Transcatheter embolization for hemorrhage from aberrant testicular artery after partial nephrectomy: A case report. World J Clin Cases 2023; 11:7852-7857. [DOI: 10.12998/wjcc.v11.i32.7852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Revised: 09/06/2023] [Accepted: 11/02/2023] [Indexed: 11/16/2023] Open
Abstract
BACKGROUND Arterial bleeding typically involves the renal artery following partial nephrectomy; in this study, we present a case of bleeding originating from the testicular artery that has not been reported in previous studies.
CASE SUMMARY A 52-year-old man suffered hemorrhage from a perinephric branch of the aberrant left testicular artery after an open nephron-sparing surgery for renal cell carcinoma. Clinical signs of bleeding were manifested by the patient, such as fresh blood drainage from the catheter, decreased hemoglobin levels, and significant vital sign changes. Since computed tomography did not show evidence of active bleeding, transcatheter angiography was conducted to identify the bleeding site. Fluoroscopic spot images confirmed bleeding derived from a perinephric branch of the testicular artery originating from the segmental artery of the left renal artery. Using n-butyl-2-cyanoacrylate, successful transcatheter arterial embolization of the affected branch was performed. Immediately after the embolization procedure, the bleeding ceased, and the patient experienced complete recovery devoid of complications.
CONCLUSION In patients with postoperative arterial hemorrhage after partial nephrectomy, the testicular artery can be a rare but notable source of bleeding. Accurate bleeding site localization via angiographic evaluation, followed by transcatheter arterial embolization, can be instrumental for safe, prompt, and effective hemostasis.
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Affiliation(s)
- Juyoun Youm
- Department of Radiology, Dankook University Hospital, Cheonan 31116, South Korea
| | - Min-Jeong Choi
- Department of Radiology, Dankook University Hospital, Cheonan 31116, South Korea
| | - Bong Man Kim
- Department of Radiology, Dankook University Hospital, Cheonan 31116, South Korea
| | - Yumi Seo
- Department of Urology, Dankook University Hospital, Cheonan 31116, South Korea
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Visalli C, Salamone I, Mormina E, Gaeta M. Intratesticular Vascular Architecture Seen by Ultrasound Microvascular Imaging (MicroV). Illustration of the Testis Vascular Anatomy. Curr Med Imaging 2023; 20:CMIR-EPUB-134303. [PMID: 37691203 DOI: 10.2174/1573405620666230906092245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Revised: 07/10/2023] [Accepted: 07/22/2023] [Indexed: 09/12/2023]
Abstract
The testis is a richly vascularized organ supplied by low-flow thin caliber vessels that are only partially detected by traditional Doppler systems, such as color and power Doppler. However, in the vascular representation, these techniques determine, albeit to different extents, a cut of the weak vessels due to the necessary application of wall filters that cut the disturbing frequencies responsible for artifacts generated by pulsations of the vascular walls and surrounding tissues. These filters cut a specific range of disturbing frequencies, regardless of whether they may be generated by low-flow vessels. Recently, a new technology, called Ultrasound Microvascular Imaging (MicroV) has been developed, which is particularly sensitive to slow flows. This new mode is based on new algorithms capable of better selecting the low frequencies according to the source of origin and cutting only the disturbing ones, saving the frequencies originating from really weak flows. When Ultrasound microvascular imaging is used, the vascular map is more detailed and composed of macro and microvasculature, with more subdivision branches, facilitating the interpretation of the normal and, consequently, the pathological. This review aims to describe the vascular architecture of the testis with Ultrasound Microvascular Imaging (MicroV) in healthy testis, compared to traditional color/power Doppler, related to normal anatomy.
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Affiliation(s)
- Carmela Visalli
- Department of Biomedical and Dental Sciences and of Morphofunctional Imaging, University of Messina, Italy
| | - Ignazio Salamone
- Department of Biomedical and Dental Sciences and of Morphofunctional Imaging, University of Messina, Italy
| | - Enricomaria Mormina
- Department of Biomedical and Dental Sciences and of Morphofunctional Imaging, University of Messina, Italy
| | - Michele Gaeta
- Department of Biomedical and Dental Sciences and of Morphofunctional Imaging, University of Messina, Italy
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Fadl AM, Abdelnaby EA, El-Sherbiny HR. Supplemental dietary zinc sulfate and folic acid combination improves testicular volume and hemodynamics, testosterone levels and semen quality in rams under heat stress conditions. Reprod Domest Anim 2022; 57:567-576. [PMID: 35147249 DOI: 10.1111/rda.14096] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 02/08/2022] [Accepted: 02/09/2022] [Indexed: 11/30/2022]
Abstract
This study was aimed to investigate the combined effect of zinc sulfate and folic acid (ZnF) dietary supplementation on testicular hemodynamics (TH), testicular volume (TV), serum testosterone levels (T) and semen quality of rams under heat stress conditions. Fifteen Ossimi rams were allocated to three groups: (1) G0 (n=5) received only basic diet; (2) G1 (n=5) received basic diet + ZnF (Zn, 0.4 mg/kg bw; F, 0.02 mg/kg bw) and (3) G2 (n=5) received basic diet + ZnF (Zn, 0.8 mg/kg bw; F, 0.04 mg/kg bw) daily for 60 days. TH was evaluated using color (testicular coloration, TC) and spectral modes [resistive index (RI) and pulsatility index (PI)] Doppler of the supra testicular arteries (proximal and distal parts, STA). Semen traits including progressive motility (PM), alive sperm % (AS), sperm viability (SV), sperm abnormalities (SA) and acrosome integrity (AI) were also assessed. The examinations were carried out one month before (D -30), the beginning of ZnF inclusion in the diet (D 0), and continued for the successive two months (D 30 and D 60). TH was significantly (P < 0.05) improved at D 30 and D 60, evidenced by lowering both RI and PI and increasing of TC in G1 compared to G0 and G2. In addition, both TV and serum T levels were elevated (P < 0.05) at D 30 and D 60 in G1 compared to other groups. Semen quality parameters (PM, AS, SV and AI) were significantly (P < 0.05) augmented in the same trend as TH, TV and T in G1 versus G0 and G2. A marked decrease (P < 0.05) in SA % was noticed at Days 30 and 60 after ZnF inclusion in G1 compared to G0 and G2. In conclusion, supplementation of the summer diet with ZnF improved the whole reproductive functions such as testicular hemodynamics and semen quality of rams housed in heat stress conditions.
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Affiliation(s)
- Aya M Fadl
- Theriogenology Department, Faculty of Veterinary Medicine, Cairo University, Egypt
| | - Elshymaa A Abdelnaby
- Theriogenology Department, Faculty of Veterinary Medicine, Cairo University, Egypt
| | - Hossam R El-Sherbiny
- Theriogenology Department, Faculty of Veterinary Medicine, Cairo University, Egypt
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El-Shalofy AS, Hedia MG. Effects of buserelin administration on testicular blood flow and plasma concentrations of testosterone and estradiol-17β in rams. Domest Anim Endocrinol 2021; 77:106646. [PMID: 34175682 DOI: 10.1016/j.domaniend.2021.106646] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 04/28/2021] [Accepted: 05/24/2021] [Indexed: 12/12/2022]
Abstract
This research aimed to examine for the first time the impact of single dose administration of gonadotropin-releasing hormone (GnRH) analog buserelin acetate on the testicular blood flow measurements (peak systolic velocity [PSV], end-diastolic systolic velocity [EDV], resistive index [RI], and pulsatility index [PI]) and the plasma steroids (testosterone and estradiol-17β) concentrations in rams. For this purpose, twelve adult Ossimi rams were randomly assigned into the buserelin group (n = 8) and were injected intravenously (iv) with buserelin acetate (0.008 mg/ram), whereas the remaining rams (n = 4) were injected with normal saline iv and served as a control group. Blood sampling and testicular pulsed-wave Doppler scanning were conducted immediately before (0) and 1, 3, 6, 24, 48, 72, 120, and 168 h after treatment. The control group did not reveal any substantial changes (P > 0.05) in the examined parameters, except for the EDV (P < 0.05). In the buserelin-treated group, a marked reduction in RI and PI values (P < 0.05) occurred 1 to 3 h after administration of buserelin. Besides, there was a significant increase in testosterone plasma concentrations following buserelin treatment. In conclusion, the administration of buserelin triggered a series of substantial changes in the testicular blood perfusion and steroidogenesis that could have a positive effect on testicular function in rams.
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Affiliation(s)
- A S El-Shalofy
- Department of Theriogenology, Faculty of Veterinary Medicine, Cairo University, Giza, 12211, Egypt.
| | - M G Hedia
- Department of Theriogenology, Faculty of Veterinary Medicine, Cairo University, Giza, 12211, Egypt.
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Balci S, Ardali Duzgun S, Arslan S, Balci H, Karcaaltincaba M, Karaosmanoglu AD. Anatomy of testicular artery: A proposal for a classification with MDCT angiography. Eur J Radiol 2021; 142:109885. [PMID: 34364047 DOI: 10.1016/j.ejrad.2021.109885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 07/19/2021] [Accepted: 07/26/2021] [Indexed: 11/20/2022]
Abstract
PURPOSE Knowledge of normal anatomy and variations of testicular arteries are critical for planning before minimally invasive surgery. In this article, we aimed to evaluate the morphological characteristics of testicular arteries by MDCT and propose a new classification system. METHOD A total of 400 adult patients (total of 819 testicular arteries) who underwent abdominal CT angiography examination for several unrelated reasons were enrolled in this study. Testicular arteries (TAs) were evaluated in terms of number, origin, course, and caliber. Based on our findings, we also proposed a novel anatomical classification for the TAs according to their origin (divided into 5 types-type 1-5-) and course (divided into three types-type a-c-). Type 4 origin and type a course are the expected normal origin and course of bilateral TAs. RESULTS The most common type based on the origin was type 4, with the testicular artery originating from the abdominal aorta, inferior to the level of the renal artery within 5 cm distal to the renal arteries. 70.7% of the right and 75.6% of the left testicular arteries were type 4. The most common type of the vessel course was the normal expected trajectory (type a) with an incidence of 76.3% for the right and 82.6% for the left testicular arteries. CONCLUSION Normal anatomy and variations of testicular arteries may be effectively evaluated by CT angiography in a non-invasive manner.
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Messana G, Ambrosi L, Moramarco LP, Cionfoli N, Maestri M, Quaretti P. Testicular artery originating from the inferior mesenteric artery: an alert for interventionalists - A case report. Radiol Case Rep 2021; 16:2710-2713. [PMID: 34336075 PMCID: PMC8318830 DOI: 10.1016/j.radcr.2021.06.059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 06/20/2021] [Indexed: 11/19/2022] Open
Abstract
Testicular arteries usually arise from the abdominal aorta. During an elective embolization of superior rectal arteries for hemorrhoidal disease performed in a 52-year-old male patient, a previously unreported vascular variant was identified. On selective angiography, the inferior mesenteric artery split into left colic artery and left testicular artery, without any evidence of vascular supply to the hemorrhoidal cushions. Superior rectal arteries were embolized after catheterization of the median sacral artery. A thorough knowledge of vascular variations is essential for interventional radiologists in order to recognize them and avoid potential complications.
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Affiliation(s)
- Gaia Messana
- Department of Radiology, IRCCS Policlinico San Matteo Foundation, Viale Camillo Golgi, 19 27100 Pavia PV, Italy
- Corresponding author.
| | - Ludovico Ambrosi
- Department of Radiology, IRCCS Policlinico San Matteo Foundation, Viale Camillo Golgi, 19 27100 Pavia PV, Italy
| | - Lorenzo Paolo Moramarco
- Unit of Interventional Radiology - Department of Radiology, IRCCS Policlinico San Matteo Foundation, Viale Camillo Golgi, Pavia PV, Italy
| | - Nicola Cionfoli
- Unit of Interventional Radiology - Department of Radiology, IRCCS Policlinico San Matteo Foundation, Viale Camillo Golgi, Pavia PV, Italy
| | - Marcello Maestri
- Department of General Surgery I, IRCCS Policlinico San Matteo Foundation, Viale Camillo Golgi, Pavia PV, Italy
| | - Pietro Quaretti
- Unit of Interventional Radiology - Department of Radiology, IRCCS Policlinico San Matteo Foundation, Viale Camillo Golgi, Pavia PV, Italy
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Padur AA, Kumar N. Unique variation of the left testicular artery passing through a vascular hiatus in renal vein. Anat Cell Biol 2019; 52:105-107. [PMID: 30984464 PMCID: PMC6449590 DOI: 10.5115/acb.2019.52.1.105] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2018] [Revised: 10/01/2018] [Accepted: 10/23/2018] [Indexed: 11/27/2022] Open
Abstract
Surgeons should have a thorough knowledge regarding the morphologic variations of the testicular arteries as any injury to this artery during surgery might cause testicular atrophy. We report in here an unusual course of left testicular artery and discuss its embryological basis and its clinical implications. The left testicular artery had a high origin from the anterior aspect of the abdominal aorta at the level of origin of renal artery. In its further course, the left testicular artery passed through a hiatus present in the left renal vein. This unusual course of the testicular artery through the vascular hiatus might lead to its entrapment and is worth reporting in efforts to educate clinicians involved in abdominal and urogenital surgical procedures.
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Affiliation(s)
- Ashwini Aithal Padur
- Department of Anatomy, Melaka Manipal Medical College (Manipal Campus), Manipal Academy of Higher Education, Manipal, India
| | - Naveen Kumar
- Department of Anatomy, Melaka Manipal Medical College (Manipal Campus), Manipal Academy of Higher Education, Manipal, India
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Durán-Sánchez EO, Mendivil-Guerrero CA, García-Norzagaray JC, Villalobos-López JA, Valle-Leal JG. [Aneurisma de arteria testicular: reporte de un caso y revisión de la literatura]. Bol Med Hosp Infant Mex 2018; 75:373-376. [PMID: 30407451 DOI: 10.24875/bmhim.18000017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background Aneurysm of the testicular artery is a rare entity; the term is described as the dilation of any blood vessel in the body. Case report An 18-year-old patient with a left testicular artery aneurysm, with no family or personal history of medical importance, presented for consultation due to a volume increase of long evolution in the inguinal region, accompanied by sporadic pain with no other symptoms. The testicular artery aneurysm was not detectable preoperatively by ultrasound, which only reported data compatible with left inguinal hernia and varicocele. The diagnosis was made postoperatively by a histopathological study. This case highlights the presentation of a true aneurysm of the testicular artery and the result after definitive surgical treatment. Conclusions The etiology of the aneurysm and pseudoaneurysm reported in the literature is described after a testicular trauma and, a few cases of congenital origin. The clinical manifestations are pain and an inguinal mass, which can be frequently confused with inguinal hernias or an aggregated pathology. Therefore, the approach of patients with inguinal or testicular pathology should be protocolized and include aneurysm within the differential diagnoses.
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Affiliation(s)
- Edgar O Durán-Sánchez
- Departamento de Cirugía General, Hospital General Regional Número Uno, Instituto Mexicano del Seguro Social. Ciudad Obregón, Sonora, México
| | - César A Mendivil-Guerrero
- Departamento de Angiología y Cirugía Vascular, Unidad Médica de Alta Especialidad 167. Ciudad Obregón, Sonora, México
| | - Juan C García-Norzagaray
- Departamento de Cirugía General, Hospital General Regional Número Uno, Instituto Mexicano del Seguro Social. Ciudad Obregón, Sonora, México
| | - Jesús A Villalobos-López
- Departamento de Cirugía General, Hospital General Regional Número Uno, Instituto Mexicano del Seguro Social. Ciudad Obregón, Sonora, México
| | - Jaime G Valle-Leal
- Departamento de Enseñanza e Investigación, Hospital General Regional Número Uno, Instituto Mexicano del Seguro Social. Ciudad Obregón, Sonora, México
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Qi X, Wang K, Zhou G, Xu Z, Yu J, Zhang W. The role of testicular artery in laparoscopic varicocelectomy: a systematic review and meta-analysis. Int Urol Nephrol 2016; 48:955-65. [PMID: 26971102 DOI: 10.1007/s11255-016-1254-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Accepted: 02/23/2016] [Indexed: 11/24/2022]
Abstract
PURPOSE We performed this meta-analysis to evaluate the efficacy and safety of artery preserving versus artery non-preserving in laparoscopic varicocelectomy. METHODS All publications up until October 2015 were searched in PubMed, EMBASE, Ovid, Web of Science, and Cochrane library. Randomized controlled trials (RCTs) and cohort studies (CSs) that compared the difference in two operative approaches in laparoscopic varicocelectomy were included. Statistical analysis was performed using Stata version 12.0. RESULTS A total of four RCTs and ten CSs involving 503 cases with artery preserving and 911 cases with artery non-preserving met our inclusion criteria. Meta-analysis showed that artery preserving had higher recurrence rate [risk ratio (RR) = 2.91, 95 % confidence interval (CI) 1.83-4.61; P = 0.000], lower incidence of hydrocele formation (RR = 0.18; 95 % CI 0.08-0.42; P = 0.000), and prolonged operating time [standard mean difference (SMD) = 1.27; 95 % CI 0.17-2.37; P = 0.023], compared with artery non-preserving in laparoscopic varicocelectomy. The results were similar in postoperative catch-up growth (RR = 1.00; 95 % CI 0.86-1.17; P = 0.985) and testicular atrophy (RR = 0.36; 95 % CI 0.09-1.54; P = 0.169). Besides, no significant difference was found in sperm concentration, motility, and normal morphology between two groups, as well as on postoperative pregnancy rate (RR = 0.95; 95 % CI 0.65-1.40; P = 0.809). CONCLUSION With the advantages of less recurrence, easier operating and less time spending, and comparable results in other respects, artery non-preserving is preferable to artery preserving in laparoscopic varicocelectomy, although there is a relatively high incidence of hydrocele formation. Considering the limitation of included studies, more large-scaled RCTs are required to confirm the present findings.
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Affiliation(s)
- Xiaokang Qi
- Department of Urology, Subei People's Hospital, No. 98 Nantong West Road, Yangzhou, 225001, Jiangsu, China.,Department of Urology, The First Affiliated Hospital of Nanjing Medical University, No. 300 Guangzhou Road, Nanjing, 210029, Jiangsu, China
| | - Kunpeng Wang
- Department of Urology, The First People's Hospital of Lianyungang City, No. 182 North Tongguan Road, Xinpu District, Lianyungang, 222002, Jiangsu, China
| | - Guangchen Zhou
- Department of Urology, Subei People's Hospital, No. 98 Nantong West Road, Yangzhou, 225001, Jiangsu, China
| | - Zhen Xu
- Department of Urology, The First Affiliated Hospital of Nanjing Medical University, No. 300 Guangzhou Road, Nanjing, 210029, Jiangsu, China
| | - Junjie Yu
- Department of Urology, Subei People's Hospital, No. 98 Nantong West Road, Yangzhou, 225001, Jiangsu, China
| | - Wei Zhang
- Department of Urology, The First Affiliated Hospital of Nanjing Medical University, No. 300 Guangzhou Road, Nanjing, 210029, Jiangsu, China.
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Mao QH, Li J. An Accessory Renal Artery Originating from the Testicular Artery, a Rare Variant. Indian J Surg 2016; 77:549-50. [PMID: 26884670 DOI: 10.1007/s12262-015-1346-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Accepted: 09/03/2015] [Indexed: 11/25/2022] Open
Abstract
Renal artery variations including their source, number, and course are very common. Accessory renal arteries were discovered frequently on the left side; these arteries entered the upper or lower poles of the kidney. The present cadaver showed a testicular artery origin of the accessory renal artery, which was seldomly described previously.
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Affiliation(s)
- Qing Hua Mao
- Department of Neonatal Intensive Care Unit, First People's Hospital, Jining, Shandong 272000 China
| | - Jing Li
- Department of Anatomy, Academy of Basic Medicine, Jining Medical University, Shandong, 272067 China
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Mazengenya P. Multiple variations of the renal and testicular vessels: possible embryological basis and clinical importance. Surg Radiol Anat 2016; 38:729-33. [PMID: 26507071 DOI: 10.1007/s00276-015-1584-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Accepted: 10/22/2015] [Indexed: 10/22/2022]
Abstract
During routine dissection of the abdominal cavity of a 55-year-old African male cadaver, multiple anomalies including renal and testicular vessels were encountered. The right kidney was supplied by three right hilar renal arteries arising from the abdominal aorta at different vertebral levels whereas only one left renal artery supplied the left kidney. On the right three renal veins drained the kidney into the inferior vena cava. In contrast, the left kidney was drained by a single renal vein which received a large primary posterior tributary. The primary posterior tributary had three tributaries from the posterior lumbar region. The right testis had two sources of arterial supply; one from the subcostal artery and another from the abdominal aorta. The left testis was supplied normally by a single testicular artery. The right testis was drained by four testicular veins as follows: one drained into the subcostal vein, the other two drained separately for a longer course and joined shortly before draining into the right main renal vein, the fourth one drained into the anterior aspect of the inferior vena cava at the level of the second lumbar vertebra. On the left, the testicle was drained by two testicular veins which travelled separately from the deep inguinal ring and joined shortly before they drain into the left renal vein. This variation may represent an immature form of complicated development of kidneys and testes. Additionally, emphasis must be put on preoperative vascular examination to avoid surgical complications from variant vessels in this region.
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12
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H. M, D’Souza AS, P. V, Ray B, Suhani, Pallavi. A Cadaveric Study about the Anomolous Origin of Testicular Arteries Arising from the Accessory Renal Arteries. Indian J Surg 2015; 77:111-6. [PMID: 26139964 PMCID: PMC4484524 DOI: 10.1007/s12262-012-0737-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2012] [Accepted: 09/10/2012] [Indexed: 11/27/2022] Open
Abstract
Testicular arteries are paired vessels, arising from the abdominal aorta, at the level of second lumbar vertebra. Variations in the origin of these vessels highlight a potential importance regarding the vascular supply to the gonads and kidneys. This study was designed to assess the variations in the origin, course, and distance about the point of origin of the testicular arteries. The posterior abdominal walls of 40 male cadavers were studied on either side, during routine dissection in the Department of Anatomy, Kasturba Medical College, Manipal. A majority had a normal course and the variations were reported as: a) Bilateral origin of gonadal arteries from accessory renal arteries, b) Unilateral origin of the gonadal artery from the left accessory renal artery, and c) Unique origin of the right testicular artery from the right inferior epigastric artery and left testicular artery from descending thoracic aorta above the aortic opening of the diaphragm. Due to the embryological attribution, these variations in the testicular arteries indicate an alarming threat to the radiologists and surgeons during renal transplants and nephrectomies, as these vessels monopolize the vascular supply to the gonads. This study was undertaken to document the incidence of testicular arteries originating from accessory renal arteries.
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Affiliation(s)
- Mamatha H.
- Department of Anatomy, Kasturba Medical College, Manipal University, Manipal, 576104 Karnataka India
| | - Antony Sylvan D’Souza
- Department of Anatomy, Kasturba Medical College, Manipal University, Manipal, 576104 Karnataka India
| | - Vinodhini P.
- Department of Anatomy, Kasturba Medical College, Manipal University, Manipal, 576104 Karnataka India
| | - Biswabina Ray
- Department of Anatomy, Kasturba Medical College, Manipal University, Manipal, 576104 Karnataka India
| | - Suhani
- Department of Anatomy, Kasturba Medical College, Manipal University, Manipal, 576104 Karnataka India
| | - Pallavi
- Department of Anatomy, Kasturba Medical College, Manipal University, Manipal, 576104 Karnataka India
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13
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Patel AP, Lowe GJ, Zynger DL. Rethinking the value of sending vasectomy specimens for histologic examination: an analysis of arterial vasculature and failure to transect the vas deferens. Am J Clin Pathol 2014; 141:360-6. [PMID: 24515763 DOI: 10.1309/ajcpaphjeg2j5mif] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
OBJECTIVES The testicular, deferential, and cremasteric arteries and their branches surround the vas deferens (VD), leaving them susceptible to injury during vasectomy. Literature describing the caliber of arteries seen in vasectomy specimens is lacking, making it difficult to categorize the significance of an observed artery. We aimed to establish reference values for arterial size typically encountered in vasectomy specimens and assess our institutional experience with failure to transect the VD. METHODS The luminal diameter of the largest artery in 231 consecutive VD specimens from 116 patients was measured microscopically. For comparison, the diameter of the largest artery within 10 spermatic cord cross-sections from inguinal orchiectomies was obtained. The immediate vasectomy failure rate based on histologic assessment was calculated using specimens from 2008 to 2012. RESULTS The luminal diameter of the largest artery encountered in a vasectomy specimen was 1.00 mm or less in 96.5% of cases. Artery sizes greater than or equal to 2.50 mm were only seen in spermatic cord resections. From 2008 to 2012, three (0.36%) of 837 patients undergoing vasectomy had specimens that showed failure to transect both VD. CONCLUSIONS Although the American Urologic Association and European Association of Urology state that histologic evaluation of vasectomy specimens is not required, we encourage the surgeon to send VD specimens for histologic examination. Doing so allows early identification of the failure to transect the VD and the resection of surrounding vasculature, providing quality control feedback to the surgeon.
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Affiliation(s)
- Abhishek P. Patel
- Departments of Urology, The Ohio State University Medical Center, Columbus, OH
| | - Gregory J. Lowe
- Departments of Urology, The Ohio State University Medical Center, Columbus, OH
| | - Debra L. Zynger
- Pathology, The Ohio State University Medical Center, Columbus, OH
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