Microsurgical testis autotransplantation. A critical review

Abdominal testes represent 15 to 25% of all cases of cryptorchidism. In 5% the testis is so high in the abdomen that it is impossible to perform a conventional orchidopexy. The authors report an experience of 5 cases of testicular autotransplantation achieved by temporarily severing the testicular vessels and then reanastomosing them to the inferior epigastric vessels using a microsurgical technique with an operating microscope at 25 times magnification. Compared to traditional methods, autotransplantation permits an easy replacement of an ectopic testis into the scrotum and a more physiological blood supply to the testis. The authors discuss surgical and microsurgical techniques, testicular ischemia time and follow-up of patients who have undergone autotransplantation.