Epididymal polar dissociation: a previously undescribed anatomical variant.

Stephen Mccain,David Mark,Scott Mccain,Robin Brown

doi:10.1155/2014/360436

Abstract

The normal male external genitalia include the testicles with the epididymis attached posteriorly and the vas deferens arising from this. This case describes an anatomical variation of this normal anatomy not previously reported in the literature. A 17-year-old boy presented with symptoms of intermittent testicular torsion and underwent scrotal exploration. On the left side there was a bell-clapper deformity with the epididymis separated into two parts with the lower pole high in the scrotum and attached to the tunica vaginalis. A normal vas deferens was seen to arise from the isolated lower pole of the epididymis. There was no connection between the vas deferens and the testis or upper pole of epidiymis. This case reminds us of the possibility of anatomical variations and the importance of keeping them in mind to prevent complications at time of surgery.

Highlights

An understanding of the anatomy of the male external genitalia, namely, the scrotum, testicles, epididymis, and cord structures, is crucial during the exploration of the testis in cases of suspected torsion
Upper pole of epididymis and testis separated from the lower pole by long thin mesentery Tunica vaginalis with “bell-clapper”
The male external genitalia include the scrotum which contains the testicles with the epididymis lying along the posterior border of the testicle

Summary

Introduction

An understanding of the anatomy of the male external genitalia, namely, the scrotum, testicles, epididymis, and cord structures, is crucial during the exploration of the testis in cases of suspected torsion. Awareness of the possible variations that may exist is necessary for appropriate surgical management and the prevention of complications during this and other urology operations. There is a recognised increased risk of complications in procedures with anatomical variations [1, 2]. This case report reveals an anatomical variant of the epididymis and vas deferens not previously described in the literature. There is a brief discussion of the normal anatomy and some complications that have been described up until now

Case Presentation

Findings

Discussion