TESTICULAR ARTERY RAMIFICATION WITHIN THE INGUINAL CANAL

Testicular arterial anatomy has been well studied because of its important role in testicular physiology and testicular surgery. Contrary to classical anatomical descriptions, we have observed that often more than 1 branch of the internal spermatic artery is present at the level of the proximal inguinal canal. Many surgeons who perform varicocelectomy assume that only 1 artery is present at this level and ligate all other vascular structures once an artery has been identified. We determine the frequency and number of internal spermatic arteries present within the spermatic cord in the proximal inguinal canal. The number of internal spermatic arteries present at this level was studied in 15 spermatic cords of 12 patients undergoing varicocelectomy using loupe magnification and intraoperative Doppler ultrasound. The number of arteries ranged from 1 to 3, with a mean of 2 arteries. Histological studies of the same area of 17 spermatic cords obtained from cadavers revealed a mean of 2.4 arteries (range 1 to 3). Knowledge of the frequent early branching of the internal spermatic artery will prevent inadvertent interruption of testicular arterial blood flow during operations performed upon the spermatic cord within the inguinal canal.