A unique combination of triple abnormality in a willed male body donor dissection, with putative clinicopathological correlations during the subject's lifetime, is described in this case report. The subject had a three-piece artificial urinary sphincter surgically implanted around the proximal corpus spongiosum, left scrotal pouch and in the lower left abdominal wall, ostensibly for urinary incontinence during his lifetime, though the etiology of the latter was not immediately obvious. He also had a total of three accessory renal arteries involving both sides, complicated by bilateral diffuse renal atrophy from presumable glomerulosclerosis or nephrosclerosis-induced nephrotic syndrome. While each entity may not be so unique per se, each is not too common either. The combination of all three findings has not been described to date in the contemporary literature in a single male cadaver dissection. Only seven reports of artificial urinary sphincter studies on human cadaver subjects could be detected in contemporary literature, this being the eighth. Finally, there were no apparent etiopathological or pathogenetic mechanisms to explain the occurrence of each or the coexistence of all of them in a single male cadaveric subject. The artificial urinary sphincter was reviewed with respect to its characteristics, placement, and efficacy. An attempt was made to establish the cause-effect relationship between the artificial sphincter and urinary incontinence that necessitated the implant. Thereafter, a clinicopathological correlation was proposed in this case report to reconcile the concomitance of urinary incontinence, bilateral accessory renal arteries, and bilateral renal atrophy. An embryogenetic mechanism of the aberrant renal arteries was also suggested. Physician awareness from the standpoint of preoperative investigation of such cases was also highlighted.

This original article postulates a pathophysiological association between two uncommon clinical entities in a cadaveric subject. A female cadaver from a willed body donor was procured for educational and research purposes. During surgical dissection, the subject was observed to have hallux valgus (HV) and lateral plantar venous thrombosis (PVT) on the left foot. Clinical significance of HV was confirmed by geometric measurements of the great toe and first metatarsal. Severity of lateral PVT was established by meticulous dissection along full course of the vein and all its grossly accessible tributaries. Dissections in other regions of the same cadaveric subject did not reveal evidence of venous thrombosis elsewhere. Extensive search of the contemporary literature confirmed HV is most common in elderly females, though not very common in the general population. It also established that isolated PVT is very rare, the medial type being rarer. No study mentioned both HV and PVT in the same subject or tried to establish a pathophysiological association between both entities. Analyzing the pedobarographic and phlebology literature on HV, PVT, foot veins, gait, posture, and foot pressure points led the authors to postulate that flattening of medial arch and increased medial forefoot pressure from HV during life in elderly females could render Uhl-Gillot’s postulated ‘footpump’ incompetent. Since the principal conduit of the foot-pump is the lateral plantar vein (LPV), ineffective foot-pump could lead to lateral PVT. Considering the paucity of literature on coexisting HV and PVT in living and cadaveric subjects, more studies are required to confirm our hypothesis of this pathophysiological association.