TESTICULAR AUTOTRANSPLANTATION FOR THE INTRAABDOMINAL TESTIS

Oftentimes patients with intra-abdominal testes require more than the standard procedure to accomplish orchiopexy. Division of the spermatic vessels has been one mainstay of operative approaches for the intra-a bdominal testis since Fowler and Stephens (Congenital Malformations of Rectum, Anus, and Genitouriary Tracts, chapter 19, pp 306-320, 1963) provided an anatomically rational basis for this procedure. Silber and Kelly (J Urol, 115:452-454, 1976) first described using a microvascul ar anastomosis to bring extra blood supply to the testicle after mobil ization of a high intraabdominal testicle into the scrotum; however, t his approach has not been adopted by many for a number of reasons. The microvascular skill and instrumentation required for a successful ana stomosis are not universally available and there is a misconception th at the procedure is a lengthy one (Bianchi, Br J Urol 56:521-524, 1984 ; Bogaert et al., Urology 42:182-188, 1993). We present our series for testicular autotransplantation used over a 17 year period with a grea ter than 95% success. (C) 1995 Wiley-Liss, Inc.