The Experts below are selected from a list of 1218 Experts worldwide ranked by ideXlab platform
Naveen Kumar - One of the best experts on this subject based on the ideXlab platform.
-
unique variation of the left Testicular Artery passing through a vascular hiatus in renal vein
Anatomy & Cell Biology, 2019Co-Authors: Ashwini Aithal Padur, Naveen KumarAbstract:Surgeons should have a thorough knowledge regarding the morphologic variations of the Testicular arteries as any injury to this Artery during surgery might cause Testicular atrophy. We report in here an unusual course of left Testicular Artery and discuss its embryological basis and its clinical implications. The left Testicular Artery had a high origin from the anterior aspect of the abdominal aorta at the level of origin of renal Artery. In its further course, the left Testicular Artery passed through a hiatus present in the left renal vein. This unusual course of the Testicular Artery through the vascular hiatus might lead to its entrapment and is worth reporting in efforts to educate clinicians involved in abdominal and urogenital surgical procedures.
-
Unique Case of Entwined Left Testicular and Left Renal Artery Forming an Arterial Arch Over the Left Renal Vein
Light House Polyclinic Mangalore, 2017Co-Authors: Ashwini Aithal P, Naveen Kumar, Swamy Ravindra S, Gayathri S PrabhuAbstract:Testicular arteries are the main arteries supplying the testis. An anatomical variation in the course of the left Testicular Artery and left renal Artery is presented in this case report, highlighting its clinical implications. The left Testicular Artery had a high origin from the anterior aspect of the abdominal aorta and took a recurrent course. On reaching the upper border of the left renal vein, it looped over it and descended in front of it. The left renal Artery had normal origin and normal course of its proximal half. Thereafter, it arched over the superior border of renal vein and appeared on its anterior surface to reach the renal hilum, causing a mild tortuous course of the Artery. This arching of Testicular Artery and renal Artery over the left renal vein might compress the renal vein resulting in renal vein hypertension. This unusual course might also compress the Testicular Artery causing Testicular and pelvic varicocele. Hence, an abnormal course of Testicular Artery often warrants clinical attention because of its importance in maintaining thermoregulation and proper spermatogenesis of the testis
-
A unique case of bifid left Testicular Artery having its anomalous high origin from renal Artery
Wolters Kluwer Medknow Publications, 2016Co-Authors: Ashwini P Aithal, Naveen Kumar, Swamy S Ravindra, Jyothsna PatilAbstract:The Testicular arteries are known to originate from the ventrolateral aspect of the abdominal aorta and descend obliquely to the pelvic cavity and supply the testis. An anatomical description of an uncommon variation of the left Testicular Artery is presented in this case report, highlighting its clinical implications. During routine dissection of a male cadaver, we found that the left Testicular Artery was bifid and it was arising from the left renal Artery. After its origin, it then coursed behind the left renal vein, passed between the left Testicular vein and left ureter and at the lower pole of the left kidney, this bifid Testicular Artery joined to form a single Testicular Artery which thereafter presented a normal course. Anatomy of the Testicular Artery has been studied in detail because of its importance in Testicular physiology, as well as its significance in Testicular and renal surgery. This vascular variation shows a major significance in renal surgery, partial or total nephrectomy, and renal transplant. In addition, this anatomical variation enhances the importance of arteriography or the Doppler ultrasound examination of the renal hilum before surgeries
-
arterial glomerulus at the hilum of the right kidney and the abnormal course of the right Testicular Artery a case report
Acta medica Iranica, 2014Co-Authors: B S Nayak, Naveen Kumar, Srinivasa Rao Sirasanagandla, Regunathan DeepthinathAbstract:Variations in the origin of arteries in the abdomen are very common. With the invention of new operative techniques within the abdomen cavity, the anatomy of abdominal vessels has assumed a great deal of clinical importance. We report here a rare case of formation of an "arterial glomerulus" at the hilum of the right kidney by the branches of right renal Artery. There were 2 renal veins; a superficial and a deep. The deep vein had a peculiar course through the arterial glomerulus. The right Testicular vein drained into the deep renal vein. We also observed a variant origin and course of right Testicular Artery. Prior knowledge of unusual branching pattern of renal vessels is necessary in the surgical interventions which require hilar dissection. Similarly, abnormal origin or course of Testicular Artery becomes apparent during surgical procedures like varicocele and undescended testes. Therefore, knowledge of such an anomaly in the Testicular Artery helps to avoid iatrogenic injuries during radiological or surgical procedures.
-
high origin of left Testicular Artery associated with its peculiar arched course a rare anatomical variation
INTERNATIONAL JOURNAL OF CLINICAL AND SURGICAL ADVANCES, 2014Co-Authors: Naveen Kumar, Ashwini P Aithal, Jyothsna Patil, Ravindra S Swamy, Satheesha B Nayak, Surekha D ShettyAbstract:Testicular arterial morphology deviating from its normal anatomy is a serious concern, as diagnostic approaches in male infertility and varicocele can be often linked with its associated vascular anomaly. We report here a case of remarkably high origin and peculiar course of left Testicular Artery in an elderly male cadaver aged approximately 60 years. The Testicular Artery arose from abdominal aorta at the level of origin of renal Artery deep to renal vein. In its further course it ascended obliquely upwards and to the left, behind the suprarenal vein. At the lateral border of suprarenal vein, it descended downwards by arching the renal vein. It then coursed vertically downwards superficial to renal vein. This peculiar course of Testicular Artery is vulnerable for iatrogenic injury during surgical approaches in this region. Prior knowledge of high origin and variant course of Testicular Artery is noteworthy before planning and performing any surgical and radiological interventions.
Marc Goldstein - One of the best experts on this subject based on the ideXlab platform.
-
incidence and postoperative outcomes of accidental ligation of the Testicular Artery during microsurgical varicocelectomy
The Journal of Urology, 2005Co-Authors: Peter T K Chan, James E Wright, Marc GoldsteinAbstract:PURPOSE: In this study the frequency and outcomes of unintentional Testicular Artery ligation during microsurgical varicocelectomy were evaluated. MATERIALS AND METHODS: From 1984 to 2002, 2,102 cases of microsurgical varicocelectomy were evaluated. Accidental Artery ligation was confirmed intraoperatively by observation of pulsatile twitching of the ligated vessel stump under 25x magnification. RESULTS: The complication was identified in 19 cases (0.9%) and all occurrences were unilateral, with 74% on the left side and 42% on the right side. In addition to the vasal Artery at least 1 alternative Artery was identified in all cases. Average testis volume before surgery was 15.8 ml. Azoospermia was found in 26% of cases. After surgery during the median followup of 19 months Testicular atrophy developed in 1 patient (5%). In this cohort significant improvement was found in serum total testosterone in 80% (from 362 to 493 ng/dl) and in sperm count in 80% (from 12 to 22 x 10 per ml). Return of motile sperm to the ejaculate was found in 40% of azoospermic cases. The natural pregnancy rate was 14%, which is significantly lower than the 46% previously reported in the historical cohort of varicocelectomy cases. CONCLUSIONS: The incidence of accidental Testicular Artery ligation in microsurgical varicocelectomy was approximately 1%. Testicular atrophy developed in 1 patient (5%). Preservation of cremasteric and/or secondary internal spermatic arteries likely contributed to a low incidence of adverse outcomes. The natural pregnancy rate was low which may be due to the high proportion of azoospermic men before surgery. It is possible that the smaller testes usually associated with azoospermia indicate smaller Testicular arteries, thus posing a greater risk of accidental ligation.
-
intraoperative characterization of arterial vasculature in spermatic cord
Urology, 2004Co-Authors: Jay D Raman, Marc GoldsteinAbstract:Abstract Objectives To characterize the arterial microanatomy within the spermatic cord. Methods Between June 2002 and March 2003, 72 men underwent 120 microsurgical subinguinal varicocelectomies for the treatment of varicocele. A micro-ruler was used to measure the diameter of each Artery in the spermatic cord at the external inguinal ring. Results A single Testicular Artery was identified in 83 (69%), two Testicular arteries in 32 (27%), and three arteries in 4 (3%) of 120 cases. The Testicular Artery diameter ranged from 0.2 to 1.9 mm (mean 1.0). A single vasal Artery was identified in 117 (98%) of 120 cases, with the vasal Artery diameter ranging between 0.2 and 1.8 mm (mean 0.6). A single cremasteric Artery was identified in 66 (55%), two arteries in 37 (31%), and three arteries in 5 (4%) of 120 cases. The cremasteric Artery diameter ranged from 0.1 to 1.5 mm (mean 0.5). The diameter of the Testicular Artery was equal to or greater than the sum of the vasal and cremasteric Artery diameters in 69 (57.5%) of 120 spermatic cords. Conclusions The Testicular Artery was consistently the largest caliber arterial vessel, with a diameter equal to or greater than the sum of the vasal and cremasteric arteries in more than 50% of the spermatic cords. This suggests that although the vasal and cremasteric arteries combined contribute significantly to the Testicular blood supply, the Testicular Artery provides most of the blood flow to the human testes. Preservation of the Testicular arteries is recommended for optimal Testicular blood flow.
-
microsurgical inguinal varicocelectomy with delivery of the testis an Artery and lymphatic sparing technique
The Journal of Urology, 1992Co-Authors: Marc Goldstein, Bruce R Gilbert, Adam P Dicker, Jack Dwosh, Claire GneccoAbstract:AbstractConventional techniques of varicocele repair are associated with substantial risks of hydrocele formation, ligation of the Testicular Artery, and varicocele recurrence. We describe a microsurgical technique of varicocelectomy that significantly lowers the incidence of these complications. The testicle is delivered through a 2 to 3cm. inguinal incision, and all external spermatic and gubernacular veins are ligated. The testis is returned to the scrotum and the spermatic cord is dissected under the operating microscope. The Testicular Artery and lymphatics are identified and preserved. All internal spermatic veins are doubly ligated with small hemoclips or 4-zero silk and divided. The vas deferens and its vessels are preserved.Initially, we performed 33 conventional inguinal varicocelectomies in 24 men without delivery of the testis or use of a microscope. Postoperatively, 3 unilateral hydroceles (9%) and 3 unilateral recurrences (9%) were detected. For the next 12 cases 2.5X loupes were used result...
Ashwini Aithal Padur - One of the best experts on this subject based on the ideXlab platform.
-
unique variation of the left Testicular Artery passing through a vascular hiatus in renal vein
Anatomy & Cell Biology, 2019Co-Authors: Ashwini Aithal Padur, Naveen KumarAbstract:Surgeons should have a thorough knowledge regarding the morphologic variations of the Testicular arteries as any injury to this Artery during surgery might cause Testicular atrophy. We report in here an unusual course of left Testicular Artery and discuss its embryological basis and its clinical implications. The left Testicular Artery had a high origin from the anterior aspect of the abdominal aorta at the level of origin of renal Artery. In its further course, the left Testicular Artery passed through a hiatus present in the left renal vein. This unusual course of the Testicular Artery through the vascular hiatus might lead to its entrapment and is worth reporting in efforts to educate clinicians involved in abdominal and urogenital surgical procedures.
Douglas G. Rogers - One of the best experts on this subject based on the ideXlab platform.
-
Spontaneous Idiopathic Arteritis of the Testicular Artery in Raccoons (Procyon lotor)
2016Co-Authors: A. N. Hamir, J. Stasko, M. Palmer, Douglas G. RogersAbstract:Abstract. The testes and the spermatic cord of raccoons (Procyon lotor, kits to adult breeders; n 5 48) were examined. Segmental arteritis confined to the extraTesticular portions of the Testicular Artery was present in raccoons of all ages. The arterial changes were seen in laboratory-confined experimental and control animals as well as in wild-caught raccoons. The lesions consisted of proliferative endarteritis with presence of inflammatory cells within the intima, media, and the adventitial regions of most affected vessels. Some aspects of the proliferative arterial lesions were reminiscent of systemic necrotizing vasculitis (polyarteritis nodosa), an immunologically mediated condition of animals and humans. Etiologic agents were not identified at the affected sites. Arteritis was not attributed to the administration of infectious agents because it was present in raccoons of all age and origin. To our knowledge multifocal arteritis confined to the Testicular Artery has not previously been documented in raccoons. Key words: Arteritis; extraTesticular Artery; proliferative arteritis; raccoons (Procyon lotor). Raccoons (Procyon lotor) are highly adaptable omnivores that are found throughout North America and in some areas of Europe and Asi
-
Spontaneous idiopathic arteritis of the Testicular Artery in raccoons (Procyon lotor).
Veterinary Pathology, 2009Co-Authors: A. N. Hamir, J. Stasko, Douglas G. RogersAbstract:The testes and the spermatic cord of raccoons (Procyon lotor, kits to adult breeders; n = 48) were examined. Segmental arteritis confined to the extraTesticular portions of the Testicular Artery was present in raccoons of all ages. The arterial changes were seen in laboratory-confined experimental and control animals as well as in wild-caught raccoons. The lesions consisted of proliferative endarteritis with presence of inflammatory cells within the intima, media, and the adventitial regions of most affected vessels. Some aspects of the proliferative arterial lesions were reminiscent of systemic necrotizing vasculitis (polyarteritis nodosa), an immunologically mediated condition of animals and humans. Etiologic agents were not identified at the affected sites. Arteritis was not attributed to the administration of infectious agents because it was present in raccoons of all age and origin. To our knowledge multifocal arteritis confined to the Testicular Artery has not previously been documented in raccoons.
Kenneth I Glassberg - One of the best experts on this subject based on the ideXlab platform.
-
adolescent varicocelectomy does Artery sparing influence recurrence rate and or catch up growth
Journal of Andrology, 2014Co-Authors: Angela M Fast, Shannon N Nees, Christopher M Deibert, Jason P Van Batavia, Kenneth I GlassbergAbstract:Summary The prevalence of varicocoeles is 15% in the general adolescent and adult male population and in 35–40% of men evaluated for infertility. While varicocelectomy can be performed using various methods and techniques, the laparoscopic approach allows for clear visualization of the Testicular Artery and lymphatics. Amongst urologists, particularly paediatric urologists, and andrologists there is much debate regarding the significance of Testicular Artery sparing when performing a varicocelectomy, with some believing that ligating the Testicular Artery impairs catch-up growth and future fertility. On the other hand, several studies have reported higher failure rates with Artery preservation. To help resolve the debate regarding the significance of Artery sparing, we sought to compare varicocoele recurrence rate and catch-up growth in patients who underwent Artery sparing laparoscopic varicocelectomy compared with those who had the Artery sacrificed. We identified 524 laparoscopic varicocelectomies in 425 patients from our adolescent varicocoele database. Only patients who had ultrasound determined Testicular volume measurements pre-operatively and at least 6 months post-operatively were included. Post-operative persistence/recurrence of varicocoele, Testicular atrophy and repeat varicocelectomy were noted. Catch-up growth was compared between procedures in those with significant pre-operative asymmetry. Four hundred and forty primary laparoscopic varicocelectomies were performed in 355 patients (mean age: 15.5 years, range 9.3–20.6; mean follow-up: 32.9 months, range 6.0–128.9) who had both pre- and post-varicocelectomy scrotal Duplex Doppler ultrasound performed. The Testicular Artery was preserved in 54 varicocoeles (41 patients) and ligated in 384 varicocoeles (312 patients). We observed an increased rate of persistent/recurrent varicocoele in the Artery-sparing vs. Artery ligating patients (12.2% vs. 5.4%, p = 0.09). In addition, there was no difference in catch-up growth and no instance of Testicular atrophy. As Artery sparing varicocelectomy offered no advantage in regards to catch-up growth and was associated with a higher incidence of recurrent varicocoele, preservation of the Artery does not appear to be routinely necessary in adolescent varicocelectomy.
