The pampiniform plexus is a network of about 8-12 interconnected veins in the spermatic cord, wrapped around the testicular artery. It drains the testis and epididymis and gradually merges as it ascends, forming the testicular vein near the deep inguinal ring. The right testicular vein drains into the inferior vena cava and the left into the left renal vein.
| Origin | Veins of the testis and epididymis |
|---|---|
| Course | Ascends in the spermatic cord in front of the ductus deferens around the testicular artery, through the inguinal canal, and unites into the testicular vein near the deep inguinal ring |
| Branches |
|
The plexus acts as a heat exchanger, cooling arterial blood going to the testis and helping keep the testis a few degrees below core temperature for normal sperm production. Dilation of the plexus produces a varicocele, which is much more common on the left, partly because the left testicular vein joins the renal vein at a right angle and lacks valves more often. A new right-sided or non-collapsing varicocele in an adult warrants imaging to exclude obstruction by a tumour.
Dilated veins of the pampiniform plexus felt as a soft swelling above the testis, described as a bag of worms, more prominent on standing. It can be associated with reduced fertility and testicular shrinkage and is treated by surgery or embolisation when indicated.
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