The gonadal (testicular or ovarian) nerve plexus accompanies the gonadal vessels from the aortic plexus, carrying sympathetic fibres from T10-T11 to the gonads. The testicular plexus runs along the spermatic cord and the ovarian plexus runs in the suspensory ligament of the ovary.
Gonadal plexus pathology produces referred flank and testicular or ovarian pain in retroperitoneal conditions — a common presentation of renal colic. Gonadal vein and plexus division is required during laparoscopic retroperitoneal surgery. Varicocele treatment (testicular plexus ligation) reduces the hyperadrenergic state of the pampiniform plexus. Ovarian plexus involvement in endometriosis produces central sensitised pelvic pain.
Testicular or ovarian pain referred via the gonadal nerve plexus from retroperitoneal pathology including renal calculus, retroperitoneal haematoma, or lymphadenopathy, producing flank-to-gonadal pain without local genital pathology.
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