Abstract
ABSTRACTObjectives:In this review we will describe the testicular vessels anatomy and the implications of these vessels in surgical treatment of high undescended testis.Material and Methods:We performed a narrative review of the literature about the role of the testicular arteries anatomy in the treatment of high undescended testis. We also studied two human testes to illustrate the testicular vascularization.Results:Each testis is irrigated by three arteries: testicular artery (internal spermatic artery), a branch of the right aorta; deferential artery (vasal artery), a branch of the inferior vesicle artery that originates from the anterior trunk of internal iliac artery and cremasteric artery (external spermatic artery), a branch of the inferior epigastric artery. There are important communications among the three arteries with visible anastomotic channels between the testicular and deferential arteries.Conclusions:Laparoscopic transection of the testicular vessels by dividing the spermatic vessels (Fowler-Stephens surgery) is safe in patients with high abdominal testis due to the great collateral vascular supply between testicular, vasal and cremasteric arteries; also, two-stage Fowler-Stephens orchiopexy appears to carry a higher rate of success than the single stage approach.
Highlights
Cryptorchidism is the consequence of lack or insufficiency of the process of testicular descent taking place during fetal life [1]
In this study we carried out a review about the role of the testicular arteries anatomy in the treatment of high undescended testis
The recommended age for orchidopexy was reduced to below 1 year based on findings of germ cell loss in the undescended testicle at 1 to 2 years of age and findings that orchidopexy performed at 9 months compared with 3 years had a more significant beneficial effect on the growth of the previously undescended testicles [2]
Summary
Cryptorchidism is the consequence of lack or insufficiency of the process of testicular descent taking place during fetal life [1]. Undescended testis is one of the most common genital diseases identified at birth and the most common surgical problem in pediatric urology. The main justification for treatment is to reduce the increased risks of infertility, testicular malignancy, and/ or torsion/trauma as well as inguinal hernia associated with the undescended testis [2]. In Europe, the percentage of individuals with cryptorchidism ranges from 2% to 8%, 6% in the United Kingdom [3]. 2% to 8% of full-term newborns have one or both testes not descended at birth [4, 5]. Goel [6] reports a percentage between 1% and 4% in full-term newborns and 30% in preterm infants
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