Testicular revascularization using arterial without venous anastomosis for intraperitoneal cryptorchism

An eleven-year-old boy with bilateral intraperitoneal cryptorchism underwent transabdominal orchiopexy. The right internal spermatic vessels had to be divided to allow for scrotal transposition. Because of previous inguinal exploration, only the right inferior epigastric artery was found. The accompanying veins could not be identified. Therefore, the testicle was revascularized by an arterial without venous anastomosis. Perivasal collaterals were relied on to carry the venous return. The postoperative result was excellent, providing a testicle of growing size in the inferior scrotum nine months after surgery. Testicular revascularization in the management of intraperitoneal cryptorchism currently provides 85 to 90 per cent chance for a successful scrotal transposition when the testicular blood supply must be divided. This case suggests that only the arterial micro-anastomosis is necessary for the management of this difficult surgical problem. Further experience is needed to validate this concept.