Vascular organization of the pampiniformis plexus in the man and its significance for antegrade sclerosing of testicular varicocele

Abstract

The vascular organization of human spermatic cord was analyzed by means of injection and by casting preparation of the testicular artery and veins of the pampiniform plexus after orchiectomy. After leaving the human testis, the testicular veins are organized in two main groups and form two vein plexus. One of these vein groups forms a tight plexus around the testicular artery. Computer-aided 3-D reconstructions based on the paraffin serial sections of the human spermatic cord allowed us to demonstrate the relation between the blood vessels and the other tissue structures of the spermatic cord. The results obtained allowed us to subdivide the human spermatic cord into three compartments. The dorsomedial compartment contains the vas deferens and its blood vessels. The middle compartment contains the testicular artery and the vein group which forms a tight plexus around this artery. The ventrolateral compartment contains a vein group which shows no topographic relation to the testicular artery. This vein group is embedded in a large, macroscopically visible volume of fatty tissue. To be sure of sparing the testicular artery during antegrade sclerotherapy this vein group should be prepared.