1. Volume 51, Issue 5, Pages 1402-1410 (May 2007)
The Complex Structure of the Smooth Muscle Layer of Spermatic Veins and Its Potential Role in the Development of Varicocele Testis 
Derya Tilki, Ergin Kilic, Robert Tauber, Dietrich Pfeiffer, Christian G. Stief, Roland Tauber, Süleyman Ergün 
European Urology 
Volume 51, Issue 5, Pages (May 2007)
DOI: /j.eururo
Copyright © 2006 European Association of Urology Terms and Conditions

2. Fig. 1
Casting preparations of large veins of the spermatic cords show frequent and dense back-to-back constrictions of the venous wall (arrows) (×300) (A). Longitudinal histologic section through a spermatic vein confirms these periodical constrictions of the venous lumen (arrow) (×350) (B).
European Urology  , DOI: ( /j.eururo )
Copyright © 2006 European Association of Urology Terms and Conditions

3. Fig. 2
Cross-section of a normal large spermatic vein shows an outer longitudinal smooth muscle layer (OM) in the tunica adventitia in addition to the regular inner smooth muscle layer (IM) of the tunica media (A) (×250). Semi-thin cross-section of a large spermatic vein clearly shows the inner (IM) and the outer (OM) smooth muscle layer of the tunica media and adventitia (B). The arrow points out the muscle fibres branching from the outer to the inner smooth muscle layer (B) (×450). The following longitudinal semi-thin section through the spermatic venous wall impressively demonstrates smooth muscle fibres branching from the outer (OM) to the inner muscle (IM) layer interlacing both (arrow head) (×300) (C). The drawing (D) summarises our findings of the structural assembly of the wall of large spermatic veins and shows the relation between both muscle layers and their role for vascular wall contraction. The arrowhead again points out the circularly running branches from the outer (OM) to the inner (IM) smooth muscle layer. The coordinated contraction of both muscle layers probably serves the morphologic basis for the observed and here displayed constrictions of the venous wall. The arrow marks the endothelial layer.
European Urology  , DOI: ( /j.eururo )
Copyright © 2006 European Association of Urology Terms and Conditions

4. Fig. 3
Semiquantitative evaluation of the degenerative changes in varicocele veins demonstrates that all varicocele veins studied (n=20) exhibit structural changes of their venous wall (A). The following two cross-sections of veins (B, C), which had been taken out during antegrade sclerosing of varicoceles grades I and II, reveal a degraded outer muscle layer compared (OM) with normal veins. Another venous cross-section demonstrates changes of varicocele grade III with only a few outer smooth muscle bundles (OM) and an additional degradation of the inner muscle layer (IM) of the tunica media (D). (Hematoxyline-eosine; ×250).
Two semi-thin sections from veins of varicocele grade I (E) and III (F) document the gradual differences in the degree of degenerative changes of the venous wall: the spectrum of changes ranges from low-grade changes of the outer smooth muscle layer (OM) (E) to an intense degeneration of the two smooth muscle layers of the venous wall (OM, IM) (F). (Toluidine blue-pyronine; ×250).
European Urology  , DOI: ( /j.eururo )
Copyright © 2006 European Association of Urology Terms and Conditions

5. Fig. 4
Immunohistochemistry of human spermatic cord tissue for vWF (endothelial marker) shows the following. The outer smooth muscle layer of the venous wall (V) (A) exhibits a much higher vascularisation (arrowhead) than the wall of the artery (Art) (B). Small veins (sv) of the spermatic cord near the artery do not show an outer longitudinal smooth muscle layer (B) (×250). Immunohistochemical staining for NF-200 reveals, in comparison with normal spermatic veins (C), a gradual reduction of nerve density (arrows) in the wall of varicocele veins (D–F) (×400).
European Urology  , DOI: ( /j.eururo )
Copyright © 2006 European Association of Urology Terms and Conditions