Cardiovascular system · Pelvis · Male
Testicular arteries !
The testicular arteries come from the aorta high in the abdomen and run down through the groin; each is the main blood supply of a testis.
Official name: Testicular artery
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What it is
Long, thin arteries from the aorta, just below the kidney arteries, that run down behind the abdomen and through the inguinal canal in the spermatic cord.
What it does
The main blood supply of the testis and epididymis; their high origin recalls that the testes formed near the kidneys.
Key facts
- Origin
- Anterolateral aorta at about L2, just below the renal arteries; run down on psoas and cross the ureter
- Branches
- Ureteric branches; enter the spermatic cord at the deep inguinal ring, surrounded by the pampiniform plexus; branches to the epididymis
- Supplies
- Testis and epididymis; anastomoses with the cremasteric and deferential arteries can keep the testis alive if it is divided (Fowler-Stephens orchidopexy)
Relations
- Course
- From the aorta down and laterally behind the peritoneum on psoas major, in front of the ureter and the external iliac artery, to the deep inguinal ring; then in the spermatic cord to the back of the testis
- In front
- Right: the third part of the duodenum, the root of the mesentery and the ileocolic vessels; left: the left colic vessels and the sigmoid colon
- Deep
- In the spermatic cord, wrapped by the veins of the pampiniform plexus
How to find it
Not palpable. In the inguinal canal and scrotum it runs inside the spermatic cord, surrounded by the veins of the pampiniform plexus; in microsurgical varicocele repair it is picked out by its pulsation or with a small Doppler probe before the veins are tied.
On imaging
Color and spectral Doppler ultrasound shows flow in the testicular artery in the cord and in its capsular and intratesticular branches. Absent or reduced flow compared with the other side is the key sign of torsion; increased flow suggests orchitis. Surgery should not wait for imaging when torsion is likely. CT or MR angiography shows its origin from the aorta when needed.
Common problems
- Torsion: the cord twists and cuts off the blood supply of the testis; sudden severe scrotal pain, an emergency.
- Varicocele: widened veins of the pampiniform plexus, usually on the left, felt like a 'bag of worms'; it can affect fertility.
- An inguinal hernia can come down along it.
How it is diagnosed
Examination; Doppler ultrasound shows the blood flow (torsion) and widened veins (varicocele).
Treatment
- Emergency surgery for torsion.
- Surgery or embolisation for a varicocele that causes pain or infertility.
Clinical notes
- Its collateral links with the artery to the ductus deferens and the cremasteric artery let the testis survive if the testicular artery is tied, as in staged orchidopexy for an intra-abdominal testis
- Retroperitoneal lymph node dissection for testicular cancer follows the testicular vessels up to the renal vessels
Anatomical variants
- May arise from a renal or accessory renal artery instead of the aorta, and may pass behind the left renal vein
Development
The testis keeps its original supply from the aorta as it descends, so the artery lengthens with it.
Related conditions
Test yourself
Think of the answer, then tap the question to see it.
Where do the testicular arteries arise, and why?
From the aorta at about L2, just below the renal arteries, because the testis formed beside the kidney.
Why can the testis survive if the testicular artery is divided in Fowler-Stephens orchidopexy?
Collaterals from the artery to the ductus deferens and the cremasteric artery keep it perfused.
What does colour Doppler show in the testis when torsion cuts off testicular artery flow?
Absent or reduced flow inside the testis.
Educational information, not medical advice. For any symptom, see a health professional.
Its names
- Official Latin (TA2)
- arteria testicularis
- Official Spanish (DeCS)
- Arteria testicular
- English (TA2)
- Testicular artery
- Also called
- internal spermatic artery
Related
Sources: Anatomy, Abdomen and Pelvis: Testes.
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Representative model, for educational purposes only.