Microsurgery for intra-abdominal testicular retention

In cases of high intra-abdominal retention of the testis a standard technique of cryptorchidy treatment will not be able to bring down the testis into the scrotum. In this study we wanted to evaluate the feasibility and reliability of the technical aspects of testicular autotransplantations in children under the age of 5 years.

A series of 25 microsurgical autotranslantations of testes performed on 17 boys since July 1984 are reviewed. Emphasis was placed on the microvascular transplantation technique, the age of the patient and the long term viability of the autotransplants. An end-to-end microvascular anastomosis between the deep inferior epigastric artery and the testicular artery was performed in an end-to-end way using mattress stitches to accommodate the difference in diameter between the donor and recipient vessels. Also the testicular veins were anastomosed to the deep inferior epigastric veins.

Of the 25 transplantations (96%) were successful after a mean follow up of 24 months, the one failure was ascribed arterial thrombosis.

Our results show a 96% survival of the transplanted testes using the end-to-end vascular anastomosis as described here.