Vascular anatomy of normal and undescended testes: surgical assessment of anastomotic channels between testicular and deferential arteries.

OBJECTIVES: To demonstrate the vascular anatomy of the normal and undescended testes, emphasizing the surgical importance of the anastomotic channels between the testicular and deferential arteries in the undescended testis.
METHODS: This study was performed on four normal testes obtained from adult cadavers and the undescended testes taken from men undergoing unilateral orchiectomy. To show the arteries and their connections, we used the injection-corrosion casting technique.
RESULTS: The normal and undescended testes measured 36.3 +/- 9.2 mm x 21.2 +/- 4.3 mm x 14.3 +/- 5.4 mm and 19 x 16 x 9 mm, respectively. The testis and epididymis had an unusual shape in the undescended testes. The undescended testes were round, with a semilunar epididymis that was over the testis. All the testes, including the undescended testes, had testicular, deferential, and cremasteric arteries. The testicular, deferential, and cremasteric arterial diameter was 1.7 +/- 0.4, 1.1 +/- 0.3, and 0.5 +/- 0.3 mm in the normal testes and 1.5, 0.7, and 0.6 mm in the undescended testes, respectively. Communication among the three arteries was illustrated consistently by retrograde filling of the two noninjected arteries. Clearly visible anastomotic channels were present between the testicular and deferential arteries in the normal and undescended testes.
CONCLUSIONS: We suggest that the original Fowler and Stephans concept (high ligation of the testicular artery) is valid to preserve vascularity to the testis when vascular transection orchiopexy is performed, although the number of our specimens was not enough to prove this definitively.