Abdomen
David Heylings, Stephen Carmichael, Samuel Leinster, Janak Saada, Bari M. Logan, Ralph T. Hutchings in McMinn’s Concise Human Anatomy, 2017
Inferior vena cava - the principal vein of the body below the diaphragm, it lies on the right side of the aorta. It begins caudally at the level of the L5 vertebra by the union of the right and left common iliac veins (Figs.6.4, 6.8) and runs cranially to pierce the central tendon of the diaphragm posterior to the liver at the level of the T8- T9 vertebrae. The largest tributaries are the right and left renal veins. The gonadal vein (testicular or ovarian) drains directly into the vena cava on the right, but on the left it enters the left renal vein. The highest tributaries of the vena cava are the hepatic veins, which enter the vena cava where that vessel lies in the deep groove on the posterior of the liver (the hepatic veins therefore have no extrahepatic course). A number of small lumbar veins also enter the vena cava at various levels and connect with pelvic veins inferiorly, the azygos system superiorly and with the venous plexuses around the vertebral column.
Test Paper 7
Teck Yew Chin, Susan Cheng Shelmerdine, Akash Ganguly, Chinedum Anosike in Get Through, 2017
Varicocele is a commonly identified correctable cause of male factor infertility. Surgical correction has a failure rate of less than 5%. An alternative to surgery is the selective catheterisation and embolisation of the gonadal vein. The gonadal vein is catheterised via a common femoral vein puncture and embolic material is introduced. Indications include symptomatic varicocele, recurrence of varicocele post treatment and varicocele with associated infertility. Complications include pain, recurrence and reaction to iodinated contrast. Rupture of the testicular vein is a known complication, but it needs no specific treatment. Unlike surgery, embolisation is not associated with postoperative hydrocele or testicular loss from inadvertent injury to testicular artery. However there are case reports of renal loss from coil migration.
Kidneys and ureters
Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie in Bailey & Love's Short Practice of Surgery, 2018
The kidneys are surrounded by a distinct, well-defined envelope of perinephric fat. Nephrectomy is facilitated by staying at the true margin of the perinephric fat envelope. The perinephric fat is ‘whiter’ than colonic mesenteric fat as observed during a laparoscopic nephrectomy. At the renal hilum, the first structure encountered (i.e. the uppermost) is the renal vein, then the renal artery and lastly the renal pelvis. The right renal vein is much shorter than the left renal vein. The left renal vein is occasionally retroaortic. The right adrenal vein and right gonadal vein drain into the inferior vena cava (IVC) whereas the left adrenal and gonadal veins drain into the left renal vein. Gonadal veins can easily be confused for ureters - these structures are distinguished by pinching the ureter which contracts (vermiculation).
Surgical aspects of venous pelvic pain treatment
Published in Current Medical Research and Opinion, 2019
S. G. Gavrilov, O. I. Efremova
Venous outflow from the pelvic organs occurs via the system of internal iliac and gonadal veins. Gonadal veins carry blood from the ovaries, and the left gonadal vein drains into the left renal vein, while the right one joins the inferior vena cava below the ostium of the right renal vein. Internal iliac veins are paired vessels with valvular apparatus that have visceral and parietal tributaries. Visceral tributaries are represented by uterine, bladder, upper, middle and lower rectal veins draining the same-named venous plexuses. In addition, there is a vaginal venous plexus, which has a direct connection with the veins of the uterus and external genital organs. Vein dilation and blood reflux in the gonadal veins and tributaries of the internal iliac veins result in blood stagnation in the intrapelvic venous plexus and the development of PCS.
Varicocele management for infertility and pain: A systematic review
Published in Arab Journal of Urology, 2018
Scott D. Lundy, Edmund S. Sabanegh
A varicocele is defined as a dilated pampiniform plexus, the network of small veins responsible for venous drainage from the testicle and deep tissues of the hemiscrotum. This plexus is contiguous with the ipsilateral gonadal vein, which drains into the renal vein on the left and directly into the inferior vena cava on the right. As a result, the left renal vein is typically 8–10 cm longer and has a higher hydrostatic pressure; this explains the discrepancy in incidence between the left side (which accounts for 90% of all varicoceles) and the right side, which if tense and unilateral may be concerning for malignancy [1]. Epidemiologically, varicoceles are common and occur in 15% of the general male population (Fig. 1 ) [2,3]. Varicoceles typically develop during puberty. A large population-based study showed a prevalence of 0.92% in boys aged between 2 and 10 years and a dramatic rise to 11% in boys aged 11–19 years [4]. Men presenting with infertility have an even higher prevalence, ranging from 35% for men presenting with primary infertility [5] to 45–81% for those presenting with secondary infertility [5,6].
Comprehensive overview of the venous disorder known as pelvic congestion syndrome
Published in Annals of Medicine, 2022
Kamil Bałabuszek, Michał Toborek, Radosław Pietura
Left renal vein stenting in the management of the NCS has shown some efficacy in the treatment of PCS caused by this syndrome. However, there are few studies with small numbers of participants [118,119]. Stenting of the left renal vein is associated with a high risk of migration to the vena cava and the heart due to short vein length and change in vein diameter when the patient changes position or performs the Valsalva manoeuvre [120]. Left renal vein transposition is not always successful and it is correlated with serious complications like bleeding, thrombosis, kidney injury or infection [42,118]. In 2020 Gilmore et al. reported gonadal vein transposition in 18 patients, with complete symptom relief in 11 patients (61.1%) after a median follow-up of 178 days [121]. Complications of percutaneous embolisation are usually rare and harmless. These include recurrence of symptoms, haematoma at the puncture site, allergic reaction, embolic agent migration or coil erosion [78,122,123].
Related Knowledge Centers
- Gonad
- Inferior Vena Cava
- Ovary
- Testicular Vein
- Renal Vein
- Heart
- Blood
- Blood Vessel
- Testicle
- Ovarian Vein