I feel something like a tendon in my scrotum.

Some people will find a phenomenon when taking a shower or doing other things. For example, if they feel something like a tendon near the scrotum, it will arouse curiosity. However, there are obvious thick blood vessels on the surface of the scrotum, and there are obvious earthworm-like dilated veins in the scrotum. The venous wall is thickened and hardened; it disappears slowly when lying flat. When standing, you can see the dilated veins protruding on the scrotum, and you can feel the more obvious varicose veins in the scrotum. The mass gradually disappears when lying flat. So let's take a look at this situation below!

The spermatic cord is a round cord-like structure that extends from the deep inguinal ring (also known as the abdominal ring, through the inguinal canal) to the upper end of the testicle. It is mainly composed of three layers of membranes that wrap the spermatic cord part of the vas deferens, the inguinal part, the testicular artery, the venous plexus, the vas deferens blood vessels, the lymphatic vessels, the nerve plexus and the remnants of the peritoneal processus vaginalis.

It is a pair of soft, round cord-like structures located between the upper end of the testicle and the abdominal ring of the inguinal canal, composed of the vas deferens, testicular artery, and venous plexus wrapped in a membrane.

Testicles, epididymis, and vas deferens provide blood

2. Location

From deep inguinal canal to upper end of testis

3. Overview

The spermatic cord is a pair of soft, round cords that extend from the deep ring of the inguinal canal to the upper end of the testicle.

4. Spermatic Cord Structure

It mainly includes the vas deferens, testicular artery, racemose veins, vas deferens artery and vein, nerves, lymphatic vessels and ligamentous sheath, etc. Below the subcutaneous ring, the spermatic cord is covered with three layers of membrane (external spermatic fascia, levator testis muscle, and internal spermatic fascia).

The spermatic cord is a round cord-like structure that extends from the deep inguinal ring (also known as the abdominal ring, through the inguinal canal) to the upper end of the testicle. It is mainly composed of three layers of membranes that wrap the spermatic cord part of the vas deferens, the inguinal part, the testicular artery, the venous plexus, the vas deferens blood vessels, the lymphatic vessels, the nerve plexus and the remnants of the peritoneal processus vaginalis.

It is a pair of soft, round cord-like structures located between the upper end of the testicle and the abdominal ring of the inguinal canal, composed of the vas deferens, testicular artery, and venous plexus wrapped in a membrane.

The spermatic cord is composed of the testicular artery, vein, lymphatic vessels, nerves, levator testis, vas deferens and its covering fascia. The spermatic cord is a soft round cord that provides blood supply, lymphatic return and nerve control for the testicle, epididymis and vas deferens. If the spermatic cord is injured or surgically severed, the testicle will atrophy and lose its function. Starting from the upper end of the testicle, it passes through the external inguinal ring and inguinal canal. At the internal inguinal ring, the vas deferens turns to the pelvic cavity, while the arteries, veins, lymphatic vessels, nerves, etc. continue to ascend behind the peritoneum and connect with the corresponding tissues at the waist level. Because of the close connection between the testicles and internal organs, when the testicles or epididymis are injured or diseased, it can involve the waist and abdomen and cause pain; and when the kidneys, ureters or retroperitoneal tissues are diseased, it can also cause reflex pain in the vulva or testicles.

6. Symptoms of Varicose Cord Varicose Vein

The veins in the spermatic cord are blocked for some reason, causing blood stasis, which causes the spermatic veins to be tortuous, elongated and dilated, forming a worm-like mass in the scrotum. This is varicocele. When varicocele occurs, the scrotum is enlarged, with a heavy and bloated feeling. It gets worse when standing, walking, and working, and gets better after lying down and resting. The incidence rate can account for 10% to 15% of the male population, mostly on the left side, and about 50% to 60% of the bilateral sides are affected. Generally, the clinical symptoms are very mild or even asymptomatic, but because it may affect the production and development of sperm, it has received more attention in recent years.

7. Impact on Fertility

1. Nutritional disorders: Due to venous blood stagnation, the blood circulation of the testicles and epididymis is affected by the spermatic cord, which lacks the nutrients and oxygen they need, thus affecting sperm production.

2. Increased scrotal temperature: After varicocele, the blood stagnation in the varicocele will cause the temperature in the scrotum to gradually increase, 0.6°C higher than normal on average, thus affecting sperm production.

3. Testicular endocrine dysfunction: Due to the increase in local temperature in the scrotum and insufficient blood and oxygen supply to the testicles, the endocrine function of the interstitial cells in the seminiferous tubules of the testicles will inevitably be affected, thereby affecting the production of sperm.

4. Destructive effects of oxygen free radicals: Studies have shown that when varicocele occurs, oxygen free radicals in testicular tissue increase and lipid peroxidation worsens, thereby affecting the occurrence and function of sperm.

5. Toxin effects: Because there is a rich collateral circulation between the spermatic vein and the testicular vein, when varicocele occurs, it causes blood to flow backwards, and the high concentration of toxic metabolites carried in the left adrenal gland and the left renal venous blood can flow into the bilateral testicles before detoxification, causing sperm production to be disturbed, resulting in varying degrees of oligospermia, morphological abnormalities, and movement disorders.