Arterio-Venous Anastomosis Between Testicular Vessels; A Case Report

Objective: Varicocele is defined as dilatation of the pampiniform plexus and the internal spermatic veins which may lead to mild or moderate testicular pain. It can result in a myriad of deleterious effects on male reproduction. To diagnose and post-treatment follow-up of varicocele scrotal ultrasonography can be per- formed. The variations of the testicular arteries are common, but venous malformations are not. The anatomical variations of the testicular veins are attributed mainly to their embryologic origin. Several variations have previously been described on cadaver tissue. But arterivenous anastomosis has never been identified in living tissue. We aim to report a case diagnosed with arterivenous anastomosis between left testicular vessels during varicocelectomy. Clinical Presentation and Intervention: A 19-year-old man applied to the urology department with left testicular pain and scrotal swelling. Left varicocele was diagnosed by using physical examination and confirmed with color doppler ultrasonography of scrotum. Then left varicocelectomy was planned. In surgical treat- ment, An arterivenous anastomosis between left testicular vessels was found and treatment options were reviewed. Conclusion: In this paper, to the best of our knowledge we present the first case of arterio-venous anastomosis between testicular vessels diagnosed during varicocelectomy. Although it was previously shown on the cadaver, there was no clear opinion about diagnosis and treatment. We believe that follow-up of this variation of vessels will be considered at suitable cases. Of course it is difficult to form a clear protocol on this issue