Testicular venography for undescended testes.

Abstract

Retrograde venography of the internal spermatic vein was performed for testicular localization in 1 5 children and young adults with undescended testes. Six of the patients had bilateral studies. In 15 of the 21 venograms attempted, the internal spermatic vein was present; in the other six the testis and the internal spermatic vein were congenitally absent. The testis was accurately localized by venography in 1 3 of the 1 5 patients. In one of the two failures a competent valve prevented retrograde injection, but techniques were subsequently devised that permitted retrograde injection beyond competent valves. In the other venographic failure the left kidney was absent and no internal spermatic vein could be identified arising from the left renal vein, although at surgery the testis and the internal spermatic vein were present. Presumably the internal spermatic vein arose from the inferior vena cava, which was not explored venographically. In each of the surgically verified cases of testicular agenesis the internal spermatic vein was also absent. The anatomy of the left and right internal spermatic veins is reviewed and catheterization techniques are described. Internal spermatic venography appears to be reliable and clinically useful. Preoperative testicular localization often reduces the extent of the surgical exploration and the anesthesia time. With further experience this technique may permit accurate prediction of congenital absence of a testis.