Variant anatomy of the testicular artery among black Kenyans

Abstract

Variant anatomy of the testicular artery is important for safe surgery in the retroperioneal area, and accurate diagnosis of testicular and renal disease. The pattern of origin, number, course and branching display ethnic and geographical variations. Data from black African populations and especially Eastern Africa is scarce. The objective of this study was, therefore, to describe the topography of the intraabdominal part of testicular artery in a sample of the Kenyan population. This was a descriptive crosssectional study on one hundred (100) testicular arteries at the Department of Human Anatomy, University of Nairobi. The samples were obtained from autopsy cases and cadaveric specimens. Standard midline abdominal incisions were made, flaps of the anterior abdominal wall reflected and the intestines, mesentery and pariental peritoneum retracted systematically to expose the testicular arteries. Their site and level of origin, number, course and branching were examined. Macrographs of representative variations were taken using a high resolution digital camera. The results were analysed using SPSS version 21, and are presented using macrographs and frequency tables. Thirty three (33%) of the arteries displayed a variant anatomy, with regard to their site of origin (8%), number (4%), course (14%) and branching pattern (7%). Among the 14 cases of aberrant course, five (5%) arched over the left renal vein, eight (8%) were retrocaval and one (1%) had a retroureteric course. Seven (7%) bifurcated within the abdomen. The level of origin along the aorta varied from 1 centimetre above the renal arteries to 5.5 centimetres below them while the vertebral level of origin ranged from T12 to L4. This shows that the testicular artery among Kenyans displays a high prevalence of variant anatomy characterized by origin from the accessory renal artery, high level of aortic origin, duplication, retrocaval course and intraabdominal; division. Preopertaive evaluation of renal and gonadal vasculature is recommended to minimize misdiagnosis and inadvertent injury retroperitoneal surgery.