Angioarchitecture of the human spermatic cord

Ergün, Süleyman; Bruns, T.; Soyka, A.; Tauber, R.

doi:10.1007/s004410050825

Cited by 31 publications

(16 citation statements)

References 19 publications

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“…identified; the ideal vein for sclerotherapy is typically ventrolateral in the deep yellow fatty tissue, according to the anatomical studies of Ergun et al [14]. The vein is dissected and ligated distally.…”

Section: Methodsmentioning

confidence: 99%

Antegrade scrotal sclerotherapy for treating primary varicocele in children

2006

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persistence rate of varicoceles and complications were compared with those using other techniques. RESULTSIn 11 patients there was a palpable difference in size between the testicles, but in only five (6%) was testicular hypotrophy (testicular volume ( < 75% testicular volume vs the normal side) confirmed by US. The mean ( SEM ) operative duration for AS was 33.2 (2.14) min. In 16 (18%) patients it was necessary to expose a second or third vein because the first vein chosen was unsuitable for sclerotherapy. The mean operative radiation exposure was 2.18 (0.21) s. One patient (1%) was treated with a high ligature of the testicular vein (Palomo procedure) after initial unsuccessful AS, and was excluded from the analysis. Eighty-four (97%) patients were eligible for follow-up: six (7%) had a persistent varicocele (four grade II, two grade III), four of whom had repeat sclerotherapy successfully (no recurrence at follow-up). Fourteen (15%) patients had enlarged testicular veins only on US (varicocele grade 0). No patient developed a hydrocele after AS, There were complications after surgery in three (3%) patients (two superficial wound infections, one scrotal haematoma together with focal testicular necrosis). CONCLUSIONSAS is an efficient minimally invasive surgical method for correcting varicoceles in older children, although the operative duration is sometimes longer than in adults, and surgery can be more difficult because of the smaller veins. Partial testicular necrosis, despite correct AS, is a very rare but serious complication. KEYWORDS varicocele, antegrade sclerotherapy, children, treatment OBJECTIVETo evaluate the effectiveness and limitations of antegrade sclerotherapy (AS) for the treatment of primary varicocele in childhood. PATIENTS AND METHODSFrom December 1996 to December 2004, 88 patients (mean age 13.3 years, range 9-18) with primary varicocele underwent AS (91 varicocele ablations in all). The indications for surgery were testicular pain (16 boys, 18%), a large varicocele with cosmetic implications, testicular hypotrophy (one) and in 71 (81%) the varicocele was detected incidentally during a routine physical examination; all were left-sided. According to the classification used by Tauber, 46 (52%) varicoceles were grade II and 42 (48%) grade III. The clinical and ultrasonography (US) results were evaluated over a median (range) follow-up of 11 (3-60) months, and the operative duration, X-ray exposure time,

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Section: Methodsmentioning

confidence: 99%

Antegrade scrotal sclerotherapy for treating primary varicocele in children

2006

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“…The small (but not the large) veins anastomose directly with the spermatic artery. The large veins communicate with the artery only indirectly via veno-venous anastomoses with the small veins (10).…”

Section: Introduction Varicocelementioning

confidence: 99%

Valves of the gonadal veins

Heinz¹,

Brenner²

2010

Phlebologie

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Summary Purpose: Varicocele seems not to rely on the number of valves within the pampiniform plexus, the initial failure might be located on a higher level. Therefore, the failure should also occur in females. There is a comparable disease, Pelvic congestion syndrome, as result of pelvic venous engorgement due to gross dilatation and incompetence of ovarian veins.Thus, we need a detailed description of venous course, branching as well as frequencies and locations of valves within both genders. Page 3/23 Material and Methods: In 31 Caucasian formalin-fixed bodies (15 males, 16 females) we investigated course and valves from Ovaries or internal inguinal ring, respectively, up to termination into inferior vena cava or left renal vein, respectively. Specimens were documented photographically and by a distinct protocol. Results: In general, we found one valve on each side (testicular vein right 41.93%, left 51.52%; ovarian vein right 51.61%, left 45.45%). Two specimens had two valves per vein, each in a left testicular vein, and 15 veins showed absent valves. Valves existed between 0.0–4.5 cm, mainly 0.0–1.0 cm. One corpse showed varicose ovarian veins. Conclusion: If veins show varices, one would expect missing valves or insufficient function. In contrast, none of our 15 valve-less veins showed varices or even enlargement. Also surprising, the only case with varices had one valve on each side. The terminal segment in both genders was almost identical and the venous course was similar. Precisely: men frequently had (N=11) less valves then women (N=4).

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“…The diameters and the wall thicknesses vary and are all contorted. The vessels have mostly been classified according to their diameter in studies performed on living individuals [7,9] . Since we used specimens provided from the cadavers in our study, all the vessels were collapsed and therefore measuring the diameter was not a useful method.…”

Section: Discussionmentioning

confidence: 99%

Histomorphological Differences of Spermatic Cords regarding Subinguinal versus Inguinal Levels: A Cadaveric Study

Tüccar

Yaman²,

Erdemlı³

et al. 2009

Urol Int

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Aim: Varicocele is a common disorder among male population and is the most common cause of secondary infertility. Microsurgical inguinal or subinguinal operations are the preferred approaches but the two differ in technical difficulty. Therefore, we examined the histomorphological differences of spermatic cords at both subinguinal and inguinal levels in this cadaveric study. Methods: Spermatic cords from 9 adult male cadavers were examined at both the inguinal and subinguinal levels using a light microscope with an image analysis program in the anatomy and histology laboratories of Ankara University Medical School between July 15, 2006 and February 15, 2007. Results: In terms of number and wall thickness, we did not observe any significant histomorphological differences in spermatic cord veins and arteries between the subinguinal and inguinal levels. Conclusion: We conclude that the subinguinal approach is not a harder technique than the inguinal approach concerning vessel dissection, but more studies must be made to compare subinguinal versus inguinal varicocelectomy.

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Angioarchitecture of the human spermatic cord

Cited by 31 publications

References 19 publications

Antegrade scrotal sclerotherapy for treating primary varicocele in children

Antegrade scrotal sclerotherapy for treating primary varicocele in children

Valves of the gonadal veins

Histomorphological Differences of Spermatic Cords regarding Subinguinal versus Inguinal Levels: A Cadaveric Study

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