caa a22 4500 465771718 CHVBK 20180323111930.0 cr unu---uuuuu 170327e19900101xx s 000 0 eng 10.1007/BF00179639 doi (NATIONALLICENCE)springer-10.1007/BF00179639 Bianchi A. The Royal Manchester Children's Hospital, Hospital Road, Pendlebury, Manchester, UK aut Management of the impalpable testis [Elektronische Daten] The role of microvascular orchidopexy [A. Bianchi] Over an 8-year period at the Royal Manchester Children's Hospital, 38 intra-abdominal testes in 32 children aged 2-15 years have been transferred to the scrotum with full revascularisation by microvascular anastomosis of the testicular to the inferior epigastric vessels. Eight children had bilateral microvascular orchidopexy. Follow-up has extended from 1 to 7 years. Three testes, in boys aged 4, $$6{\raise0.5ex\hbox{$\scriptstyle 1$}\kern-0.1em/\kern-0.15em\lower0.25ex\hbox{$\scriptstyle 2$}}$$ , and 14 years, have atrophied. Strong Doppler pulsation was easily detectable over all surviving testes and cords at 6 months and 1 year postoperatively. Twenty-two testes revealed varying numbers of spermatogonia and 15 showed only Sertoli cells histologically, but all provided a normal genital appearance. Despite full information regarding complications associated with intra-abdominal testes, parents and older children preferred to retain the testis in preference to orchidectomy and a prosthesis. In view of the reliability of microvascular revascularisation in returning a full blood supply to the transferred testis, a management plan for children with impalpable testes has been developed. It is suggested that intra-abdominal testes should not be considered different from other undescended testes. Transfer to the scrotum with restoration of a full blood supply by microvascular revasularisation should preferably be undertaken before 2 years of age. Reliance on the small and delicate collateral vessels from the vas (Fowler-Stephens technique), even in the "long loop vas”, provides at best only a poor circulation when compared to full revascularisation and should be regarded only as a fall-back position in the event of a failed microvascular procedure. Springer-Verlag, 1990 Undescended testis nationallicence Impalpable testis nationallicence Microvascular orchidopexy nationallicence Pediatric Surgery International Springer-Verlag 5/1(1990-01-01), 48-53 0179-0358 5:1<48 1990 5 383 https://doi.org/10.1007/BF00179639 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/BF00179639 text/html Onlinezugriff via DOI NATIONALLICENCE 100 1- Bianchi A. The Royal Manchester Children's Hospital, Hospital Road, Pendlebury, Manchester, UK aut NATIONALLICENCE 773 0- Pediatric Surgery International Springer-Verlag 5/1(1990-01-01), 48-53 0179-0358 5:1<48 1990 5 383 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer