What Is the Spermatic Cord?

Anatomical name. It is a soft cord tissue from the upper end of the testicle to the inguinal ring. It consists of the vas deferens, the inner spermatic cord, the venous plexus, the lymphatic tissue, the nerve, and the spermatic cord envelope surrounding it. It is 11.5-15cm long and 0.5cm in diameter. When passing through the groin canal, the iliac inferior and genital nerves of the iliac and reproductive femoral nerves pass through.

Anatomical name. It is a soft cord tissue from the upper end of the testicle to the inguinal ring. It consists of the vas deferens, the inner spermatic cord, the venous plexus, the lymphatic tissue, the nerve, and the spermatic cord envelope surrounding it. It is 11.5-15cm long and 0.5cm in diameter. When passing through the groin canal, the iliac inferior and genital nerves of the iliac and reproductive femoral nerves pass through.

Chinese name

Spermatic cord

Foreign name

spermatic cord

Features

Testes, epididymis, and vas deferens provide blood

Location

Deep inguinal canal to upper testis

Sperm cord overview

The seminiferous cord is a pair of soft round cord-like structures from the deep inguinal canal to the upper end of the testis.It mainly contains the vas deferens, testicular arteries, venous plexus, vas deferens, veins, nerves, lymphatic vessels, and sheath ligaments. Below the subcutaneous ring, the spermatic cord is covered with three coats (external spermatic fascia, cremaster muscle, and inner spermatic fascia).

The seminiferous cord is a round cord-like structure that extends from the deep inguinal canal (also called the inguinal canal) to the upper end of the testis. It is mainly covered by three layers of vas deferens, the groin, the testicular artery, the venous plexus, Vascular vessels, lymphatic vessels, nerve plexus, and residual peritoneal sheath processes.

It is a pair of soft round cable-like structures located between the upper end of the testicle and the abdominal ring of the inguinal canal. It is composed of a capsule enveloping the vas deferens, testicular arteries, and venous plexus.

Spermatic cord anatomy:

There is another coating on the outside of the spermatic cord, which has three layers from the inside to the outside: The inner fascia (or total sheath) of the spermatic cord. Continuing on the transverse abdominal fascia, the cremaster and cremaster fascia are derived from the internal oblique muscle, the lower part of the transverse abdominal muscle and their fascia. The continuation of the external spermatic fascia and the external oblique tendon. The three capsules also envelop the testes and epididymis. In the inguinal canal, the distribution of the structures in the seminiferous cord is as follows: the vas deferens are located below, the vas deferens and the manifold plexus are located forward, and the arteries are located above the middle of the veins. Manifold venous plexus is composed of 10 to 12 veins, which eventually merge into testicular veins. Varicocele is more common, with 93% of patients occurring on the left. It is generally believed that this is because the left vein is longer than the right, and is injected into the left renal vein at a right angle, which makes it difficult for blood to return, but it is also related to the adjacentness of the vein and other factors.

Blood vessels, lymph and nerves: distributed by the external spermatic cord; the levator arterioles of the external spermatic cord and the external genital, vas deferens, testicular and posterior scrotal arteries are in anastomosis. The veins accompany the arteries. The lymph vessels accompanying the testicular arteries flow into the lumbar lymph nodes; the lymph vessels accompanying the vas deferens arteries flow into the extrasacral lymph nodes. The nerves include the upper spermatic nerve from the abdominal aortic plexus, the middle spermatic nerve from the lower abdominal plexus, and the lower spermatic nerve from the lower abdominal plexus. The sensory fibers are introduced with the sympathetic nerves, and enter the spinal cord through the abdominal aortic plexus and lumbar sympathetic trunk, and the 11th to 12th thoracic nerves and the 1st lumbar nerve.

The role of spermatic cord

The spermatic cord is composed of testicular arteries, veins, lymphatic vessels, nerves, testicular muscles, vas deferens, and the fascia covered by them. The seminiferous cord provides a flexible round cord for the testis, epididymis, and vas deferens to provide blood supply, lymphatic reflux, and innervation. If the spermatic cord is traumatized or the operation is severed, the testes will shrink and become inoperable. From the upper end of the testicles, through the outer groin ring and inguinal canal to the inner groin ring, the vas deferens turn to the pelvis, while the arteries, veins, lymphatic vessels, nerves, etc. continue to rise behind the peritoneum, and are connected to the corresponding tissues at the level of the waist. Because of this close connection between the testicles and the internal organs, when the testis, epididymis trauma or lesions can involve pain in the waist and abdomen, and kidney, ureter or retroperitoneal tissue lesions can also cause reflex pain in the vulva or testis.

Varicocele:

(I) Definition:

Varicocele is a vascular disease that refers to the abnormal expansion, elongation, and tortuosity of the venous plexus in the spermatic cord, which can cause pain and discomfort and progressive hypofunction of the testis. It is one of the common causes of male infertility. Varicocele is usually seen on the left side, accounting for 77% to 92%, bilaterally on 10% (7% to 22%), and rarely occurs on the right side (1%).

(II) Etiology:

The testis and epididymal veins gather into a venous venous plexus and return through three paths: Converges into the internal spermatic vein in the inguinal canal, and goes up the peritoneum. The left internal spermatic vein enters the left renal vein at a right angle, and the right spermatic cord. The internal vein merges into the inferior vena cava at an acute angle about 5 cm below the right renal vein, and about 5% to 10% directly into the right renal vein; via the vas deferens into the internal iliac vein; via the cremaster muscle vein The inferior abdominal wall vein flows into the external iliac vein.

The occurrence of primary varicocele is related to the following factors: The venous valve has the effect of preventing venous blood regurgitation. When the venous valve is absent or dysfunctional, it can cause blood regurgitation. The connective tissue of the spermatic vein wall and its surroundings is weak or the cremaster muscle is not fully developed. A person's upright posture affects venous return of spermatic cord. The varicocele of the left spermatic cord is more common than the right. The possible causes are: the left spermatic vein has a long stroke and merges into the left renal vein at a right angle, and the pressure is greater; Compression between them affects the left internal spermatic vein venous return and even leads to reflux (called the "nutcracker" phenomenon); lack of internal spermatic venous valve is more common on the left (about 40% on the left, about 40% on the right twenty three%).

Secondary varicocele can be seen in obstruction of left renal vein or vena cava tumor thrombus, renal tumor, retroperitoneal tumor, pelvic tumor, huge hydronephrosis or renal cyst, ectopic blood vessel compression and so on.

(Three) clinical manifestations:

Patients with varicocele may experience continuous or intermittent bloating, dull pain, and dull pain in the scrotum of the affected side, which is obvious when standing and walking, and is relieved after resting in the supine position. Most patients found painless earthworm-like masses in the scrotum at the time of physical examination, or they were found at the clinic due to infertility.

The effect of spermatic cord on fertility

1. Malnutrition: Due to stagnation of venous blood flow, blood circulation of testes and epididymis is affected. The lack of nutrients and oxygen required will affect sperm production.

2. Increased scrotal temperature: After varicocele stagnation, the stagnation of venous blood flow in the spermatic cord will gradually increase the temperature in the scrotum, which is 0.6 higher than normal, which affects spermatogenesis.

3, testicular endocrine dysfunction: due to local temperature rise in the scrotum, insufficient testicular blood and oxygen supply, will inevitably affect the endocrine function of interstitial cells in the seminiferous tubules of the testis, thereby affecting sperm production.

4. Destructive effects of oxygen free radicals: Studies have shown that when varicocele occurs, oxygen free radicals in testicular tissues increase and lipid peroxidation increases, which affects spermatogenesis and sperm function.

5. Toxin effect: Due to the abundant collateral circulation between the spermatic cord vein and the testicular vein, when the varicocele appears, it leads to blood reflux, which can metabolize the high concentration of toxic metabolism carried in the left adrenal gland and left renal vein blood. The product flows into the bilateral testicles before detoxification, causing sperm production to be disturbed, resulting in varying degrees of spermatozoa, abnormal morphology, and dyskinesia.