Unilateral aberrant gonadal venous anatomy coexistent with a distinct intrarenal cleft

Introduction Testicular vessels play a major role in thermoregulation of male reproductive organs, which is an essential aspect for their effective functioning. Testicular veins exhibit wide variations in their course, number and mode of termination. Case report A variation in the testicular vein was observed unilaterally in a 50year-old male cadaver during the course of a preclinical training program. Two testicular veins (medial and lateral) were present on the left side. Both medial and lateral testicular veins were found draining into the left renal vein at right angles. The lateral testicular vein displayed bifurcation close to its termination into the left renal vein. The right testicular vein followed usual course and drainage. The left kidney also exhibited a distinct intrarenal cleft. Conclusion The testicular vein variations become significant during ligation of the abnormal venous dilatations and collaterals, thereby reducing the chances of recurrence of varicocele which is a specific pathological condition causing male infertility. The present case report attempts to provide an insight into the developmental aspects and surgical importance of this unusual variation. Introduction Testicular veins are the channels arising from the pampiniform plexus of veins which is formed at the upper pole of the testis by the smaller veins draining the testis. It then traverses through the spermatic cord and at the superficial inguinal ring, four veins are formed which course through the inguinal canal and at the deep inguinal ring, these coalesce and form two or three veins. In the lumbar region, these veins combine and form a single testicular vein on the respective sides. These testicular veins ascend along the posterior abdominal wall anterior to the psoas major muscle, ureter and behind peritoneum. The right testicular vein drains into the inferior vena cava (IVC) at an acute angle, whereas the left testicular vein drains into the left renal vein at right angles1. The anatomy of testicular veins has been associated with wide variations. These variations become significant during clinical cases of varicoceles and retroperitoneal surgeries. Varicocele affecting approximately 15% of the male population is the abnormal dilatation of veins of pampiniform plexus causing testicular atrophy and male infertility2,3.