Refluent testicular autotransplantation by Domini's method

Autotransplantation presently constitutes the best option for the surgical treatment of non-palpable retained intra-abdominal testes. Silber first proposed this technique in 1978; it is not suitable in children under 3 years of age because of the small caliber of the testicular artery. In 1986 Dòmini, mindful of the problem of arterial vascularisation, carried out refluent testicular autotransplantation (RTAT), where a natural anastomosis between the testicular and deferential arteries is used. Venous drainage is guaranteed by performing a microsurgical anastomosis between the internal spermatic and inferior epigastric veins.At our institution this technique has been employed since 1990, replacing staged orchidopexy. We report a 2-year experience (1990–1992) in seven children who underwent RTAT and discuss the results obtained and the technique used.