Arise from the testicular artery, which arises from the aorta
Supply the caput and corpus epididymis
Inferior epididymal artery
Arises from the artery of the vas (vasal/deferential artery), which arises from the superior vesical artery, which arises from the internal iliac artery
Supplies the cauda epididymis
These form an extensive interconnection
Clinical implications (3)
If the artery of the vas is ligated from previous vasectomy, the blood supply to the epididymis from the testicular artery is adequate
If the testicular artery is ligated, the blood supply to the epididymis from the artery of the vas is adequate
During vasoepididymostomy or vasovasostomy, the epididymis can be intentionally dissected off the testis and mobilized to the caput, with the inferior and medial epididymal arteries intentionally ligated without adverse consequence. As long as the superior epididymal artery remains intact, the blood supply to the epididymis will be adequate
Measures between 30-35 cm in length from the cauda epididymis to its termination at the ejaculatory duct
Tortuous for 2-3 cm as it leaves the epididymis (the convoluted vas deferens)
Lumen ranges between 0.2-0.7 mm in diameter, depending on the segment
Travels posteriorly along the spermatic cord, posterior to the vessels in the cord. The vas deferens passes through the inguinal canal and enters the pelvis lateral to the epigastric vessels. On entering the pelvis, after passing through the internal inguinal ring, the vas deferens separates from the testicular vessels. The vas deferens ultimately reaches the posterior base of the prostate after traveling medial to the pelvic sidewall.
The seminal vesical (abdominal) end of the vas derives its blood supply from the artery of the vas (vasal/deferential artery)
The testicular end of the vas receives additional blood supply from the inferior epididymal arterial interconnections, which extend onto the vas deferens
The two blood supplies to the vas deferens freely anastomose with each other
After vasectomy, if [branches of] the vasal vessels are ligated, the testicular end of the vas receives all of its blood supply from the superior and middle epididymal arteries, which arise from the testiclar artery, whereas the seminal vesical (abdominal) end of the vas receives all of its blood supply from [remaining intact branches] from the artery of the vas.
The vas deferens receives no blood supply from the surrounding cremaster muscle or from any blood vessels from the spermatic cord. Therefore, if the vas deferens is sectioned or obstructed in two different locations, the intervening segment will fibrose owing to lack of blood supply. Therefore, two simultaneous vasovasostomies cannot be safely performed on the same vas if the vasal vessels have been interrupted in both locations