Clinical Significance of Intratesticular Arterial Anatomy

Testicular atrophy has been reported in 2 to 18% of the patients following orchiopexy for cryptorchidism. A possible cause of this atrophy is interference with the testicular blood supply by placement of a testicular traction suture through the tunica albuginea. Arterial casts of 32 adult human testes were created following placement of a 3-zero silk traction suture through the lower pole of the testis to determine the effects of this suture upon intragonadal arterial circulation. Significant arterial blockage, manifested as failure of the parenchymal branches to fill, was observed in 14% of the casts produced via injection through the internal spermatic artery and in 100% of the casts produced via injection through the deferential artery. The results of this study support discontinuing the routine use of parenchymal testicular traction sutures during orchiopexy.