The spermatic cord is a collection of structures that pass through the deep inguinal ring and the fascial coverings contributed by the layers of the abdominal wall. The function of the spermatic cord is to suspend the testis in the scrotum and contain structures running to and from the testis.
Where is the spermatic cord located?
The spermatic cord begins at the deep inguinal ring, lateral to the inferior epigastric vessels. Passes through the inguinal canal, and exits at the superficial inguinal ring. Ends in the scrotum at the posterior border of the testis.
What covers the spermatic cord?
- Tunica vaginalis. Covers the anterior surface of the spermatic cord just above the testis.
- Internal spermatic fascia. Transversalis/endoabdominal fascia.
- Cremasteric fascia. Fascia of internal oblique muscle. Contains loops of cremasteric muscles, which draws the testis superiorly in the scrotum when it is cold.
- External spermatic fascia. Aponeurosis of the external oblique muscle.
What does the spermatic cord contain?
- Ductus deferens. Vas deferens conveys sperm from the epididymis to the ejaculatory duct.
- Testicular artery. Arises from the abdominal aorta at L2.
- Artery of the ductus deferens. Arises from inferior vesical artery.
- Cremasteric artery. Arises from the inferior epigastric artery.
- Pampiniform plexus. Formed by up to 12 veins, drain into right and left testicular veins.
- Sympathetic nerve fibers on arteries
- Sympathetic and parasympathetic nerve fibers on the ductus deferens
- Genital branch of the genitofemoral nerve supplying the cremaster muscle
- Lymphatic vessels draining the testis and closely associated structures
- Lumbar lymph nodes
Spermatic cord and vasectomy
Some men might be concerned that their testicles will hang lower or move differently after a vasectomy. Many diagrams and illustrations indeed suggest the vas deferens are the only things attaching testicles to the body. But the vas tubes are actually just one part of the complicated group of structures in the spermatic cord, which is not damaged or cut during a vasectomy.
The spermatic cord contains arteries and veins circulating blood to and from the testes and other structures in the scrotum. This is also how testosterone made in the testicles is circulated throughout the body. The cremasteric muscles, which cause your testicles to lift when you are cold or anxious (like on the operating table), or about to ejaculate. Bunches of nerves, lymphatic vessels, and other stuff. These structures together support the testicles in the scrotum. The vas deferens are thin, hard tubes mixed up in all of this, and they are the only things cut during the procedure.
One challenge doctors face before a vasectomy is separating the vas tubes from the rest. They usually do this first at a pre-vasectomy consult (the “tube check”), when they confirm your tubes are easy to locate and that the feel of them doesn’t suggest any special problems. They do it again during the vasectomy itself before cutting.Suggested reading
The spermatic cord is a cord-like structure in the male reproductive system. Located in the groin and scrotal area, it contains arteries, veins, the cremasteric muscles, bunches of nerves, lymphatic vessels, and the vas deferens. The spermatic cord performs several physiologic functions and connects the testicles to the rest of the body.
During a vasectomy, the spermatic cord is not severed, the vas deferens are the only things in this group of structures that will be cut.
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- Galejs L. Diagnosis and treatment of the acute scrotum. Am Fam Physician. 1999;59(4):817-824. https://www.aafp.org/afp/1999/0215/p817.html
- Sam W. Spermatic cord (anatomy). YouTube. Published April 4, 2018. https://www.youtube.com/watch?v=v9eNKf3MJAo
- Spermatic cord. IMAIOS. https://www.imaios.com/en/e-Anatomy/Anatomical-Parts/Spermatic-cord
- The Spermatic Cord – Course – Fascia – Contents. TeachMeAnatomy. Published April 5, 2020. https://teachmeanatomy.info/pelvis/the-male-reproductive-system/spermatic-cord/