Testicular Lymphatic Drainage

Expansion

• Testis and epididymis - para-aortic (lumbar) nodes, at the level of L2
• Scrotal skin - superficial inguinal nodes

The testis develops on the posterior abdominal wall and drags its blood supply and lymphatic drainage with it as it descends. The scrotum is simply skin of the body wall and drains like other perineal skin.

The clinical consequences are direct:

• Testicular tumours metastasise first to para-aortic nodes, not inguinal ones, so an enlarged inguinal node in testicular cancer suggests scrotal skin involvement or previous inguinal surgery
• Staging requires abdominal imaging
• A scrotal approach to a testicular tumour is avoided, because it may seed the inguinal field and alter the drainage pattern