EQUINE VETERINARY JOURNAL

Equine vet. J. (2006) 38 (1) 35-39

35

The complex blood supply to the equine testis as a cause of

failure in laparoscopic castration
M. VOERMANS*, A. B. M. RIJKENHUIZEN and M. A.

VAN DER

VELDEN

Department of Equine Sciences, Faculty of Veterinary Medicine, University of Utrecht, Yalelaan 12, 3584 CM Utrecht, The Netherlands.
Keywords: horse; blood supply; testis;, laparoscopy; castration

Summary

Introduction

Reasons for performing study: Intra-abdominal ligation/

transection of the spermatic cord may result in necrosis of the
testis; castration of abdominal cryptorchids via laparoscopy
has therefore become common. Notwithstanding some
adaptations of the technique, a small percentage of operations
fail, prompting research into the anatomical background and
clinical relevance of the procedure.
Hypothesis: That an alternate blood supply may prevent
complete necrosis of the testis after spermatic cord transection.
Objective: To establish the prevalence of the problem in normal
and cryptorchid stallions.
Methods: In a preliminary study, the spermatic cords of
8 normal stallions were ligated and transected at different sites
and in various manners. Five weeks later the testes were
removed and the vitality of both the testes and epididymes was
evaluated. In a prospective clinical trial, intra-abdominal
spermatic cord transection was performed in 241 cryptorchid
and normal stallions. In cases of surgical failure, the testes
were removed and histology performed.
Results: Examination of the specimen removed from the
8 animals of the preliminary study revealed that all epididymes
were completely or largely spared. All except one testis were
completely necrotic. In the patients that underwent surgery all
abdominally retained testes (n = 123) were necrotic, while 5 out
of 88 inguinally retained and 8 out of 236 normally descended
testes had partially survived. The pattern of survival differed
between inguinally retained and normally descended testes. The
epididymes of these 13 horses were (largely) vital. The (partial)
survival of the epididymes and inguinally retained testes was
ascribed to an alternate blood supply via anastomosing vessels
derived from the cremasteric artery. A tributary from the
external pudendal artery was considered responsible for the
partial survival of normally descended testes.
Conclusions and potential relevance: After intra-abdominal
transection of the entire spermatic cord, 5.6% of inguinally
retained and 3.4% of normally descended testes failed to
become completely necrotic, as a result of an alternate blood
supply via the cremasteric and/or external pudendal artery.
Therefore, laparoscopic castration without orchidectomy
cannot be recommended as a trustworthy method for
castration of inguinal cryptorchids and normal stallions.

In horses, laparoscopy is used for diagnosis and treatment of

various abdominal disorders (Rijkenhuizen and van Dijk 2002).
One application is castration in the standing animal of abdominal
cryptorchids (Fischer and Vachon 1992, 1998; Davis 1997;
Hendrickson and Wilson 1997; Rijkenhuizen and Grinwis 1999).
This technique was developed to preclude peri- and post operative
complications of the inguinal or para-inguinal approach in the
recumbent animal (Fischer and Vachon 1992; Rijkenhuizen and
Grinwis 1999). After the abdominally located testis is traced and
exteriorised through a small flank incision, the spermatic cord is
ligated and transected and the testis removed (Davis 1997;
Hendrickson and Wilson 1997; Fischer and Vachon 1998).
However, in case of unilateral cryptorchidism, the normally
descended testis also has to be removed. This can be done either
by a scrotal approach in the standing horse at the same time or
later by a scrotal or inguinal approach in the recumbent animal.
Neither alternative is considered ideal.
Earlier studies performed in ponies and horses with normally
descended testes have shown that intra-abdominal ligation of the
spermatic cord resulted in avascular necrosis of the testes and
cessation of testosterone production (Wilson et al. 1996;
Rijkenhuizen and Grinwis 1999). Based on these results, intraabdominal spermatic cord ligation without orchidectomy via
laparoscopy and performed in the standing animal was introduced
as a castration method for cryptorchid as well as normal stallions
in the Equine Clinic of Utrecht University (Rijkenhuizen and
Grinwis 1999). Initially, surgical failures occurred. These were
attributed to insufficient ligation of the spermatic cord. For this
reason the surgical technique was adapted in several ways, finally
resulting in complete transection of the entire spermatic cord. The
success rate increased, but a small number of operations still failed.
From the literature, it was known that the blood supply to the
equine testis is complex (Fig 1) (Ellenberger and Baum 1932;
Sisson and Grossman 1953; Collin 1973; Jantosavicova and
Jantosavic 1983; de Lahunta and Habel 1986). The testicular
artery, with its branch the epididymal artery, is the most important
vessel. However, the deferential artery, which accompanies the
ductus deferens, as well as the cremasteric artery, situated outside
the parietal vaginal tunic, also contribute to this blood supply.
Numerous anastomosing vessels are found between these
3 arteries and, although these vessels are very small, they have the

*Author to whom correspondence should be addressed.

[Paper received for publication 10.11.04; Accepted 22.04.05]

36

The complex blood supply to the equine testis

Surgical procedures

Fig 1: Blood supply to the testis and epididymis. 1 = Spermatic cord;

2 = mesorchium; 3 = ductus deferens; 4 = testicular artery; 5 = epididymal
artery; 6 = deferential artery; 7 = cremasteric artery; 8 = external
pudendal artery; 9 = tributary from the external pudendal artery.

potential to dilate when the major blood supply to the

testis/epididymis is temporarily or permanently blocked (Collin
1973; Jantosavicova and Jantosavic 1983).
In our patients, in which the entire spermatic cords had been
transected, the blood supply to the testes via the testicular and
deferential arteries had been severed completely. Nevertheless,
some of them continued to produce testosterone. This finding
raised 2 questions: 1) do anastomosing vessels from the
cremasteric artery in some way maintain viability of the testis in a
certain number of horses previously castrated laparoscopically;
and 2) what is the incidence of this phenomenon in abdominal or
inguinal cryptorchids and in normal stallions?
In order to answer the first question, a preliminary study was
performed in 8 stallions with normally descended testes. The
spermatic cords were ligated (and transected) at different sites and
in various manners. The testes were left in place for a sufficient
time to undergo avascular necrosis. After this, they were removed
surgically. On histological examination, the vitality of both the
epididymes and testes was evaluated.
To answer the second question, we continued to perform
laparoscopic castration in cryptorchid as well as normal stallions
on the basis of informed consent from owners. With each owner
that offered a stallion for castration, different castration methods
were discussed. With regard to the laparoscopic option, they were
informed that, in a small but unknown number of cases, the
operation was not successful and, in that case, the testis would be
removed surgically without further costs.
Materials and methods

The ponies were placed in dorsal recumbency for surgery. After

sedation with detomidine (Domosedan)1 (1 mg/100 kg bwt i.v.),
general anaesthesia was induced with midazolam2 (0.06 mg/kg
bwt i.v.) and ketamine (Narketan)3 (2.2 mg/kg bwt i.v.), and
maintained with isoflurane (IsoFlo)4 and oxygen in a semiclosed
circle system with assisted ventilation. The hindlimbs were fixed
in flexion and abduction.
On both sides, the spermatic cords were approached at the level
of the external inguinal ring by incising the skin, subcutaneous
tissues and scrotal fascia, followed by blunt dissection. In Ponies 1
and 2, the left spermatic cord was crushed and ligated together with
the parietal vaginal tunic and cremaster muscle. On the right side,
the vaginal tunic was incised and only the spermatic cord ligated.
All ligatures were of polyglycolic acid (Vicryl USP 2)5 suture
material. In Pony 3, the left spermatic cord was ligated after
opening the vaginal tunic. The same procedure was performed on
the right side but, in addition, the scrotal skin, dartos and vaginal
tunic were incised at the level of the tail of the epididymis, after
which the caudal epididymal ligament was transected. In Pony 4,
the proposed procedure on the left side (ligation of the spermatic
cord and transection of the caudal epididymal ligament) failed,
after which the left testis was removed. On the right side the
spermatic cord was ligated without the vaginal tunic and the caudal
epididymal ligament was transected as described in Pony 3. In all
ponies the surgical wounds were closed.
Trotters 1 and 2 were castrated laparoscopically while standing
in stocks. They were sedated with detomidine (1 mg/100 kg bwt
i.v.) together with buprenorphine (Temgesic)6 (0.6 mg/100 kg bwt
i.v.). Subsequently, sedation was maintained with a continuous drip
infusion of detomidine (0.1 g/kg bwt/min i.v.). Local anaesthesia
at the sites of the laparoscopic and instrumental portals was
achieved by infiltration with lidocaine hydrochloride (HCl 2%)7.
Intra-abdominally, the entire spermatic cord was ligated twice
(Vicryl USP 2) and transected.
Trotters 3 and 4 were placed in dorsal recumbency under
general anaesthesia for surgery. The anaesthetic procedures and
animal positioning were the same as for the ponies. In both horses,
identical procedures were performed. On both sides, the vaginal
tunic with the spermatic cord inside and the cremaster muscle
outside was dissected free at the site of the external inguinal ring,
then crushed and ligated (Vicryl USP 2)5.
In all cases, nonsteroidal anti-inflammatory drugs were
routinely administered pre- and post operatively for 23 days.
Approximately 5 weeks later, all testes (n = 15) were removed
surgically while the animals were under general anaesthesia,
using the scrotal approach and closed technique (Schumacher
1999). In all cases, scrotal wounds were left open to heal by
second intention.
The testes and epididymes were sent to the Department of
Veterinary Pathology, Utrecht University, for macroscopic and
microscopic examination.

All work was approved by the Utrecht University Ethical Committee.

Clinical study
Preliminary study
Horses: Four male Shetland ponies (Ponies 14), age 410 years,
and 4 male trotters (Trotters 14) age 2 years were used. All
stallions were systemically healthy and had 2 normally
descended testes.

Horses: From January 2000 to January 2004, laparoscopic castration

was performed in 241 cryptorchid and normal stallions of different
breeds; all except 2 were aged at least 2 years. In 35 stallions
admitted because of unilateral abdominal cryptorchidism, the
normally descended testis had already been removed.

M. Voermans et al.

Surgical procedures
All stallions were castrated while standing in stocks and similar
anaesthetic and surgical procedures used (Rijkenhuizen and van
Dijk 2002). The anaesthetic procedures were the same as applied
in Trotters 1 and 2 of the preliminary study. In cases with a
normally descended or inguinally retained testis, the entire
spermatic cord was ligated twice (Vicryl USP 2) and transected
completely between the ligatures just above the vaginal ring. The
mesorchium was torn, allowing the distal stump of the spermatic
cord to retract into the inguinal canal. If a testis was abdominally
retained, all structures attaching to the epididymis/testis were
ligated, but not transected. Plasma testosterone concentrations
were determined (by radioimmunoassay as described by Verjans
et al. 1973) one day before and one week after surgery in order to
evaluate the success of the surgery.
Results
Preliminary study
Except for some swelling of the scrotum and inguinal region, the
animals did not show signs of discomfort after ligation/transection
of the spermatic cords. All surgical wounds healed without
complication. At the time of surgical removal, all testes were
reduced in size. On gross examination all epididymes appeared
normal. The testes were yellowish-green on the outside. On crosssection they showed dull and yellowish coloured surfaces. In one
testis (the right testis of Trotter 3), an area of vital tissue seemed
present caudally, near the insertion of the proper ligament.
Histological examination confirmed that the bodies and tails of all
15 epididymes were normal, showing normal ductuli efferentes,
which still contained spermatozoa in some cases, and normal blood
vessels in the interstitium. In 6 cases (Trotters 1, 2 and 4, both
sides), the epididymal heads were also normal, while in the other
9 they were necrotic. All except one testis were completely necrotic
and devoid of any normal testicular parenchyma. Only at the caudal
pole of the right testis of Trotter 3 were normal seminiferous tubules
surrounded by normal interstitial tissue with patent blood vessels
and viable Leydig cells present.
The various surgical procedures and respective outcome are
summarised in Table 1.
Clinical study
The laparoscopic procedure was performed on 447 testes. Of
these, 123 were abdominally retained, 88 judged as inguinally
retained and 236 as normally descended.
The operation failed in 13 stallions. These horses maintained
their stallion-like behaviour and continued to produce
testosterone. From all 13 horses, the testes were removed if
normally descended or inguinally retained and left in place if
abdominally retained. After this intervention, the stallion-like
behaviour disappeared in all horses and their plasma testosterone
concentrations reduced (reference range <25 pg/l for geldings and
>100 pg/l for stallions). Pathology of the removed testes showed
that in each of these horses one testis had not become completely
necrotic. From 13 testes, 5 had been inguinally retained and
8 normally descended. All abdominally retained testes had
become necrotic, while 5.6% (5/88) of the inguinally retained and
3.4% (8/236) of the normally descended testes had not. Hence, the

37

TABLE 1: Surgical procedures (structures ligated and transected)

performed in 4 male Shetland ponies and 4 male Trotters, and outcome
in terms of vitality of testicular and epididymal tissues

Case

Surgical procedure
2

Ponies 1 and 2
Left

X (inguinal)

Ponies 1 and 2
Right

*Body, *tail,
head

X ( inguinal)

*Body, *tail,
head

Pony 3
Left

X ( inguinal)

*Body, *tail,
head

Ponies 3 and 4
Right

X ( inguinal)

*Body, *tail,
head

Trotters 1 and 2
Left and right

X (intra-abdominal)

*Body, *tail,
*head

Trotter 3
Left and right

X ( inguinal)

*Body, *tail,
head

Left,

*Body, *tail
*head

Trotter 4
Left and right

X ( inguinal)

Outcome
Epididymis
Testis

right

X = ligation/transection. Surgical procedures: 1 = spermatic cord, testicular and

deferential arteries; 2 = vaginal tunic and cremaster muscle, cremasteric artery;
3 = caudal epididymal ligament. Outcome = *vital; necrotic; partially vital.

risk of unilateral failure in cases of bilateral laparoscopic

castration of stallions with normally descended or inguinally
retained testes varied by approximately 711%.
Histology revealed that, in testes that had been inguinally
retained, normal interstitial tissue with viable Leydig cells was
present throughout the entire testis. Testes that had descended
normally were largely necrotic and normal testicular parenchyma
was present only in the most caudal part adjacent to the proper
ligament. In all cases, the body and tail, and in some cases also the
head, of the epididymis had escaped necrosis.
Discussion
The preliminary study was executed in order to test the
hypothesis that anastomosing vessels from the cremasteric artery
might incidentally prevent complete testicular necrosis after
intra-abdominal transection of the spermatic cord. The outcome
of this study will be discussed against the background of a crossspecies literature study concerning the blood supply to the testis
and epididymis.
The anatomical aspects of the testicular, deferential and
cremasteric arteries in equids have been described by several
authors (Ellenberger and Baum 1932; Sisson and Grossman 1953;
Collin 1973; Jantosavicova and Jantosavic 1983; de Lahunta and
Habel 1986). The complex blood supply of the testis and
epididymis has also been found in other mammals, including man,
and some evidence exists about takeover of blood supply by
anastomosing vessels if blood flow through one of the major
arteries is interrupted (Harrison 1949; Jantosavicova and
Jantosavic 1982; Noordhuizen-Stassen et al. 1983; NoordhuizenStassen and Wensing 1986; King 1998). It had appeared that intraabdominal transection of the spermatic cord in prepubertal boys
and pigs did not disturb the normal development of the testicles,
but when performed in post pubertal boars, the testes became

38

completely necrotic (Noordhuizen-Stassen and Wensing 1986;

Ravasse and Delmas 1992; King 1998). In horses, the average age
at which puberty is attained is 14 months (range 1024 months)
(Senger 1999).
Examination of the specimens removed from the animals of the
preliminary study in which the spermatic cord had been transected
in the abdomen (Trotters 1 and 2) or ligated in the inguinal region
without the vaginal tunic (Ponies 1 and 2, right side; Pony 3, left
side) showed that all epididymes were completely or largely spared.
The same observation was made in our 13 unsuccessfully castrated
clinical cases. Since in all these cases the blood supply via both the
testicular and deferential arteries had been completely interrupted, it
seemed reasonable that widening of anastomosing vessels from the
cremasteric artery had prevented necrosis of the epididymis.
As the cremasteric artery runs outside the vaginal tunic, the
anastomosing vessels have to pass through that structure. The
caudal epididymal ligament, being the most distal part of the
mesorchium, forms a distinct mesenchymal connection between
the dartos outside the vaginal tunic and the tail of the epididymis
inside. This ligament is a potential pathway for the anastomoses
derived from the cremasteric artery. However, in Ponies 3 and 4,
in which the caudal epididymal ligament had been transected on
one side after ligation of the spermatic cord inside the vaginal
tunic, the epididymes remained vital. This supports the contention
that the anastomosing vessels from the cremasteric artery are
situated not only in the caudal epididymal ligament, but in a much
larger part of the mesorchium (Collin 1973; Jantosavicova and
Jantosavic 1983).
Unexpectedly, in the stallions in which the spermatic cord had
been ligated together with the vaginal tunic and cremaster muscle
(Ponies 1 and 2, left side; Trotters 3 and 4, both sides), the
epididymes also remained vital. Furthermore, in one testis (the
right testis of Trotter 3) normal testicular parenchyma was found
in its caudal portion adjacent to the insertion of the proper
ligament. As the cremasteric artery accompanies the cremaster
muscle, it was assumed that blocking of the cremasteric artery
would occur by including this muscle in the ligature. The only
explanation for the finding that after obstruction of the testicular,
deferential and cremasteric arteries the epididymis and, in a small
number of cases, even a part of the testis remained vital is that
anastomosing vessels from another artery finally take over the
blood supply to the epididymis and sometimes also to a part of the
testis. The most probable candidate is the external pudendal artery,
which courses distally through the inguinal canal outside the
vaginal tunic and divides into several branches to the superficial
inguinal lymph glands, scrotum, prepuce and parts of the penis
(Sisson and Grossman 1953; de Lahunta and Habel 1986). One
report (Jantosavicova and Jantosavic 1983) mentions that, in bulls,
anastomosing vessels exist between the external pudendal artery
and the epididymal, deferential and cremasteric arteries. Based on
the results of our study, we conclude that anastomosing vessels
from the external pudendal artery may also exist in horses. The
question is by which route these vessels may reach the epididymis
and testis. When clinically assessing the open castration with
primary wound closure several years ago, we found that, in some
cases after transection of the caudal epididymal ligament, a small
accompanying artery had to be ligated in order to prevent post
operative haemorrhage (Kersjes et al. 1985). A comparable
observation was regularly made when performing a closed
castration using the inguinal approach at the moment that the
parietal vaginal tunic was detached from the dartos. In that case,

The complex blood supply to the equine testis

the culprit was a small artery near the scrotal ligament. As the
caudal epididymal ligament and scrotal ligament are remnants of
the gubernaculum, we suggest that a small artery, originating from
the external pudendal artery, initially accompanies the scrotal
ligament and subsequently the caudal epididymal ligament, where
it anastomoses with branches from the epididymal and deferential
artery. The third remnant of the gubernaculum is the proper
ligament of the testis. Possibly, in a limited number of stallions,
this artery continues its course beyond the tail of the epididymis
along the proper ligament of the testis. After reaching the testis it
then might supply its most caudal portion, and this may be
sufficient to prevent necrosis in that area after the testicular,
deferential and even cremasteric arteries have been interrupted.
The effect of transection of the spermatic cord on the vitality
of the epididymis and testis depends upon the metabolic level
(oxygen consumption) of the affected tissues and upon the
alternate blood supply that is already present at the time of surgery
or will develop after that. Epididymal bodies and tails always
survived in our study; this was attributed to a low metabolic level
of these structures combined with an effective alternate blood
supply derived from the cremasteric artery and possibly even the
external pudendal artery. The findings concerning viability of the
epididymal heads were inconsistent. We ascribed this to the fact
that the epididymal head is supplied not by the epididymal artery
but by ramifications of the testicular artery. These ramifications,
as well as the existence of anastomosing vessels with other
arteries, vary strongly between individual stallions (Collin 1973).
In most of our patients and animals of the preliminary study the
testes became completely necrotic after ligation/transection of the
spermatic cord. Only a small number of testes partially survived, and
the pattern of survival appeared to be related to their original position.
In testes that had been inguinally retained the spermatogenic tubules
were degenerated, but normal interstitial tissue with normal Leydig
cells was found throughout the entire testis.
We suggest that the relatively frequent survival of these
inguinally retained testes was related to their low metabolic level
compared with that of normally descended testes and was effected
through widening of anastomosing vessels from the cremasteric
artery. Bergeron et al. (1998) described the unsuccessful
laparoscopic castration of a 13-month-old stallion with one
abdominally retained and one inguinally retained testis. The
abdominally retained testis had been removed, but the inguinally
retained one left in place. One year later, the horse showed
stallion-like behaviour and an apparently normal testis was
removed from the scrotum. Most probably, this testis had been
prepubertal at the time of laparoscopic castration, and its further
development had not been seriously impaired as a result of
widening of anastomosing vessels from the cremasteric artery.
In our patients, normally descended testes that had survived
spermatic cord transection appeared to be almost completely
necrotic. Only in their most caudal part was normal testicular
parenchyma still present. The same situation was seen in the right
testis of Trotter 3, in which the partial survival of the testis must
have been due to a tributary from the external pudendal artery. As
the partially survived normally descended testes in all patients
came from post pubertal stallions, their high metabolic level must
have precluded sufficient blood supply by anastomosing vessels
from the cremasteric artery. Hence, complete necrosis of the
largest part of these testes occurred. Only their most caudal part
survived, possibly because of the presence of the tributary from
the external pudendal artery.

M. Voermans et al.

Abdominally retained testes never survived spermatic cord

ligation in our study. In such cases, the ligature was applied
around all structures attaching to the epididymis/testis, being the
spermatic cord with the testicular and deferential artery, the
distal part of the caudal epididymal ligament and the distal part
of the mesorchium. The structures via which anastomosing
vessels from the cremasteric or external pudendal artery could
reach the epididymis and testis were therefore all ligated
(Rijkenhuizen and Grinwis 1999).
In conclusion, intra-abdominal transection of the spermatic
cord without removal of the testes and performed in post pubertal
stallions with normally descended or inguinally retained testes did
not succeed in 711% of cases, due to an alternate blood supply to
the testis by vessels derived from the cremasteric and/or external
pudendal artery.
Based upon the literature and extrapolating from other species
(Noordhuizen-Stassen and Wensing 1986), it must be assumed that
prepubertal stallions (colt foals) carry a larger risk of failure.
Therefore, laparoscopic castration without orchidectomy cannot be
recommended as a trustworthy method for the castration of normal
stallions and inguinal cryptorchids.

39

Davis, E.W. (1997) Laparoscopic cryptorchidectomy in standing horses. Vet. Surg.

26, 326-331.
De Lahunta, A. and Habel, R.E. (Eds) (1986) Applied Veterinary Anatomy, W.B.
Saunders Co., Philadelphia. pp 287-290.
Ellenberger, W. and Baum, H. (1932) Handbuch der Vergleichenden Anatomie der
Haustiere, 17th edn., Julius Springer Verlag, Berlin. pp 1060-1063.
Fischer, A.T. Jr. and Vachon, A.M. (1992) Laparoscopic cryptorchidectomy in horses.
J. Am. vet. med. Ass. 201, 1705-1708.
Fischer, A.T. and Vachon, A.M. (1998) Laparoscopic intra-abdominal ligation and
removal of cryptorchid testes in horses. Equine vet. J. 30, 105-108.
Harrison, R.G. (1949) The distribution of the vasal and cremasteric arteries to the
testis and their functional importance. J. Anat. 83, 267-284.
Hendrickson, D.A. and Wilson, D.G. (1997) Laparoscopic cryptorchid castration in
standing horses. Vet. Surg. 25, 335-339.
Jantosavicova, J. and Jantosavic, J. (1982) Topographisch-anatomische angaben ber
A. testicularis, A. ductus deferentis und A. cremasterica beim eber. Gegenbaurs
morphol. Jahrb. 126, 756-771.
Jantosavicova, J. and Jantosavic, J. (1983) Topographisch-anatomische angaben ber
A. testicularis, A. ductus deferentis und A. cremasterica beim hengst.
Gegenbaurs morphol. Jahrb. 129, 467-482.
Kersjes, A.W., Nmeth, F. and Rutgers, L.J.E. (1985) Atlas of Large Animal Surgery,
Ed: L.J.E. Rutgers, Bunge, Utrecht. pp 56-57.
King, L.R. (1998) Orchiopexy for impalpable testis: high spermatic vessel division is
a safe maneuver. J. Urol. 160, 2457-2460.

Acknowledgements

Noordhuizen-Stassen, E.N. and Wensing, C.J.G. (1986) Age related effects of

transection of the testicular blood vessels on subsequent testicular development
in the pig. Int. J. Androl. 9, 141-151.

The authors would like to thank Professor Dr W.A. Weijs and

Dr P.R. van Weeren for their critical reading of the manuscript and
helpful discussions.

Noordhuizen-Stassen, E.N., Dijkstra, G., Schamhardt, H.C. and Wensing, C.J.G.

(1983) Compensatory development of a patent vascular supply to the testis after
intra-abdominal transection of its main blood vessels. Int. J. Androl. 6, 509-519.

Manufacturers addresses
1Pfizer Animal

Ravasse, P. and Delmas, P. (1992) Section of spermatic vessels (Fowler-Stephens

procedure). A possible treatment for high undescended testis. Ann. Chir. 46,
497-500.
Rijkenhuizen, A.B.M. and Grinwis, G.C.M. (1999) Castration of the stallion:
preferably in the standing horse by laparoscopic techniques? Pferdeheilkunde 16,
425-429.

Health, Capelle a/d IJssel, The Netherlands.

Faculty of Veterinary Medicine, Utrecht University, The Netherlands.
3Chassot AG, Belp, Switzerland.
4AST Farma BV, Oudewater, The Netherlands.
5Johnson & Johnson Medical BV, Amersfoort, The Netherlands.
6Schering-Plough BV, Utrecht, The Netherlands.
7Eurovet, Bladel, The Netherlands.

Rijkenhuizen, A.B.M. and van Dijk, P. (2002) Diagnostic and therapeutic

laparoscopy in the horse: experiences in 236 cases. Pferdeheilkunde 18, 12-20.

References

Sisson, S. and Grossman, G.P. (1953) The Anatomy of the Domestic Animals, 4th
edn., Eds: S. Sisson, J.D. Grossman and R. Getty, W.B. Saunders Co.,
Philadelphia. pp 678-682.

Bergeron, J.A., Hendrickson, D.A. and McCue, P.M. (1998) Viability of an inguinal
testis after laparoscopic cauterization and transection of its blood supply. J. Am.
vet. med. Ass. 213, 1303-1304.

Verjans, H.L., Cooke, B.A., de Jong, F.H., de Jong, C.M.M. and van der Molen, H.J.
(1973) Evaluation of radioimmunoassay for testosterone estimation. J. Steroid
Biochem. 4, 665-676.

Collin, B. (1973) La vascularisation artrielle du testicule chez le cheval. Anat.

Histol. Embryol. 2, 46-53.

Wilson, D.G., Hendrickson, D.A., Cooley, A.J. and Degrave-Madigan, E. (1996)

Laparoscopic methods for castration of equids. J. Am. vet. med. Ass. 209, 112-114.

2Pharmacy,

Senger, P.L. (Ed) (1999) Pathways to Pregnancy and Parturition. Current

Conceptions, Inc., Moscow. pp 101-103.