Contrast-Enhanced Computed Tomography Evaluation of Testicular Vein–Perirenal Venous Connections and Anatomical Variations of Testicular Veins in Adult Males: A Retrospective Study
Vedat YamanObjectives:
Although gonadal venous drainage is traditionally considered relatively constant, perirenal venous connections to the testicular veins have been described sporadically in anatomical and surgical studies. This study aimed to determine the prevalence of testicular vein–perirenal venous anastomoses and anatomical variations of the testicular veins using contrast-enhanced abdominal computed tomography (CT).
Methods:
This retrospective single-center study included venous-phase contrast-enhanced abdominal CT examinations of 50 consecutive adult male patients. Multiplanar reformatted images were systematically reviewed to assess perirenal venous connections to the right and left testicular veins. Additionally, gonadal vein variations, including duplication and atypical drainage patterns, were also recorded.
Results:
Perirenal venous anastomoses to the testicular veins were identified in 56% of patients on the right side and 52% on the left side. Bilateral perirenal connections were observed in a substantial proportion of cases. Testicular vein duplication and atypical drainage patterns were identified, including right-sided drainage into the renal vein and rare direct left-sided drainage into the inferior vena cava.
Conclusion:
Testicular vein–perirenal venous anastomoses are frequently detectable on contrast-enhanced abdominal CT and should be regarded as common anatomical pathways rather than rare variants. These connections likely represent persistent embryological venous channels and may be under-recognized on routine imaging. Awareness of this anatomy is important for accurate radiologic interpretation and may have clinical relevance for retroperitoneal surgery and gonadal vein interventions, including varicocele treatment.