Blood Supply to the Testes

The arterial supply to the testes derives directly from the aorta where the gonadal arteries branch off at L2, just below the renal arteries. The testicular arteries travel in the spermatic cord with the cremasteric and differential artery, where they anastomose with the vasa deferentia that branch off the internal iliac artery.

Blood from the testes drain into a network of veins within the scrotum called the pampiniform plexus. This allows counter current cooling of the testis to maintain function. Defective valves or compression of the veins can cause them to become enlarged leading to varicoceles. Varicoceles can sometimes cause an aching or dragging sensation within the scrotum. At the junction of the internal inguinal ring the pampiniform plexus becomes the spermatic vein. The right spermatic vein then drains directly into the vena cava, just below the renal vein. The left spermatic vein drains into the left renal vein before it joins the vena cava, this differing pathology means that a left renal cancer may present with a left sided varicocele and these should always be investigated

Learning Bite:

Testicular torsion is due to the spermatic cord twisting, leading to ischaemia of the testis and requires emergency surgery. Torsion of the testicular appendages is a benign condition requiring supportive treatment.