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Case Report

Arterio-Venous Anastomosis Between Testicular Vessels; A Case Report


1 Department of Urology, Sultan Abdulhamid Han Education and Research Hospital, Istanbul, Turkey

2 Department of Radiology, Goztepe Education and Research Hospital, Istanbul, Turkey


DOI : 10.33719/yud.531399
New J Urol. 2019; 14 (1): 57-59

Abstract

Varicocele is defined as dilatation of the pampiniform plexus and the internal spermatic veins which may lead to mild or moderate tes- ticular pain. It can result in a myriad of deleteri- ous effects on male reproduction. To diagnose and post-treatment follow-up of varicocele scrotal ultrasonography can be performed. The variations of the testicular arteries are common, but venous malformations are not. The anatom- ical variations of the testicular veins are attrib- uted mainly to their embryologic origin. Several variations have previously been described on cadaver tissue. But arterio-venous anastomosis has never been identified in living tissue. We aim to report a case diagnosed with arterio-ve- nous anastomosis between left testicular vessels during varicocelectomy.

A 19-year-old man applied to the urology department with left testicular pain and scrotal swelling. Left varicocele was diagnosed by using physical examination and confirmed with color doppler ultrasonography of scrotum. Then left varicocelectomy was planned. In surgical treat- ment, An arterio-venous anastomosis between left testicular vessels was found and treatment options were reviewed.

In this paper, to the best of our knowledge we present the first case of arterio-venous anas- tomosis between testicular vessels diagnosed during varicocelectomy. Although it was previ- ously shown on the cadaver, there was no clear opinion about diagnosis and treatment. We be- lieve that follow-up of this variation of vessels will be considered at suitable cases. Of course it is difficult to form a clear protocol on this issue.

Keywords: Varicocele, arteriovenous, anastomosis


Abstract

Varicocele is defined as dilatation of the pampiniform plexus and the internal spermatic veins which may lead to mild or moderate tes- ticular pain. It can result in a myriad of deleteri- ous effects on male reproduction. To diagnose and post-treatment follow-up of varicocele scrotal ultrasonography can be performed. The variations of the testicular arteries are common, but venous malformations are not. The anatom- ical variations of the testicular veins are attrib- uted mainly to their embryologic origin. Several variations have previously been described on cadaver tissue. But arterio-venous anastomosis has never been identified in living tissue. We aim to report a case diagnosed with arterio-ve- nous anastomosis between left testicular vessels during varicocelectomy.

A 19-year-old man applied to the urology department with left testicular pain and scrotal swelling. Left varicocele was diagnosed by using physical examination and confirmed with color doppler ultrasonography of scrotum. Then left varicocelectomy was planned. In surgical treat- ment, An arterio-venous anastomosis between left testicular vessels was found and treatment options were reviewed.

In this paper, to the best of our knowledge we present the first case of arterio-venous anas- tomosis between testicular vessels diagnosed during varicocelectomy. Although it was previ- ously shown on the cadaver, there was no clear opinion about diagnosis and treatment. We be- lieve that follow-up of this variation of vessels will be considered at suitable cases. Of course it is difficult to form a clear protocol on this issue.

Keywords: Varicocele, arteriovenous, anastomosis