Bilateral Origin of the Testicular Arteries from the Lower Polar Accessory Renal Arteries

Abstract

SUMMARY:The gonadal arteries (testicular or ovarian arteries) emerge normally from the lateral aspect of the abdominal aorta, a little inferior to the renal arteries. Several other sites of origin of these arteries have been recorded with the renal and accessory renal arteries being the most common. In the present case report, the testicular arteries originated from the lower polar accessory renal arteries in both sides. The testicular veins followed had the usual origin and course, while an accessory renal vein was observed only in the right side. These anomalies were combined with an abnormal left ureter exiting from the lower pole of the kidney. Only one male cadaver among 77 adult human cadavers of Caucasian origin presented this set of variations (frequency: ≤ 1.3%). Variations of renal and gonadal vessels are important, as their presence could result in vascular injury of any accessory or aberrant vessel if the surgeon does not identify them.

Case Report of Unilateral Variations in Testicular and Renal Vessels: A Morphological and Clinical Study

“…These branches are divided into three groups: a cranial one (first and second arteries, proximal to the celiac trunk and posterior to the adrenal glands), an intermediate one (third to fifth arteries, which proceed on the ventral surface of the adrenal glands) and a caudal one (sixth to ninth arteries, which also follows the ventral surface of the adrenal glands). 1,12 In the majority of cases, only a single artery from the intermediate group persists, originating the renal artery. The conservation of more than one artery leads to the development of supernumerary renal arteries, such as the inferior polar ones.…”

“…Testicular arteries are described as paired visceral branches of the abdominal aorta. 1 They generally originate from the anterolateral aspect of this vessel at the level of the second lumbar vertebra, slightly below the renal arteries. They descend obliquely under the peritoneum, anteriorly to the psoas major muscle, pass through the deep inguinal ring, become a content of the spermatic cord, and end in the testicles, irrigating them.…”

“…They descend obliquely under the peritoneum, anteriorly to the psoas major muscle, pass through the deep inguinal ring, become a content of the spermatic cord, and end in the testicles, irrigating them. 1,2 In some cases, namely variations are found in the origin, number and path of those arteries. There is no consensus in literature about the variation rates: Pai et al (2008) registered 10 anomalous arteries in 34 cadavers (14.7% of the total number of arteries), 3 Asala et al (2001) reported variations exclusively on the right side of 7 out of 150 corpses (4,7% of the total number of cadavers), 4 Çiçekcibaşi et al (2002) registered variations in the origin of 14 out of the 90 evaluated testicular arteries, 5 Mamatha et al (2015) found differences in 20% of the cases, while studying 40 cadavers.…”

“…6 The accessory renal arteries are the ones described with greatest recurrence. 1 They are supernumerary arteries destined to the kidneys, being considered the most common clinically important renal vascular variation. 7 Generally, they originate from the abdominal aorta or the iliac arteries.…”

Irrigación Renal: Multiplicidad de Arterias

“…Así, Moore (1984) Oskan et al (2006) estudiaron 855 pacientes observando esta variación en 24% de los casos. Otros autores han presentado casos aislados de individuos con más de una arteria renal (Bulic et al, 1996;Loukas et al, 2005;Tanyeli et al, 2006;Deepthinath, 2006, Olave et al;Panagouli et al, 2012, entre otros).…”