testicular diseases

TESTIS AND SCROTUM.
ANATOMY OF THE TESTIS
The testes develop in the retroperitoneum below the kidneys in early fetal life. About the
same time as the wolffian duct becomes the epididymis and vas deferens, also at that
time, the precursor of the gubernaculum develops as a fold of peritoneum. The processus
vaginalis starts as a dimple of peritoneum in about the 10 th week of gestation and
precedes the testis in its journey through the abdominal wall down to the scrotum. The
fully developed gubernaculum contains muscle fibers but it is still not clear what part it
plays in testicular descent. Maternal chorionic gonadotrophin stimulates growth of the
testis and may stimulate its migration. Imperfectly developed testes tend to descend
incompletely.
The epididymis extends as a fleshy strip on the posterior aspect of the testis and is
palpable as a separate structure. The vas deferens takes its origin from the epididymis.
It can be felt above the testis as a firm tubular structure entering the external inguinal
ring.
Blood Supply
The blood supply to the testes is closely associated with that to the kidneys because of
the common embryologic origin of the 2 organs.
A. ARTERIAL
The arteries to the testes (internal spermatics) arise from the aorta just below the renal
arteries and course through the spermatic cords to the testes, where they anastomose
with the arteries of the vasa deferentia that branch off from the internal iliac
(hypogastric) artery.
B. VENOUS
The blood from the testis returns in the pampiniform plexus of the spermatic cord. At the
internal inguinal ring, the pampiniform plexus forms the spermatic vein.
The right spermatic vein enters the vena cava just below the right renal vein; the left
spermatic vein empties into the left renal vein.
Lymphatics
The lymphatic vessels from the testes pass to the lumbar lymph nodes, which in turn are
connected to the mediastinal nodes