Laparoscopic donor orchidectomy and living-related donor testicle transplantation (report of 2 cases)

Abstract

Objective To summarize the experience in laparoseopic donor orchidectomy and living-related donor testicle transplantation.Methods In 2 patients with bilateral testicular trauma leading to loss of function,serum testosterone levels were 1.94 and 1.39 nmol/L respectively,and the secondary sexual characteristics decreased or changed.One donor was from his father and the other was from his brother,whose testes were healthy.Ultrasound examinations showed testicular size,shape and blood flow were normal.The testes from the donors were acquired by laparoscopy,and the operating time was 29 and 24 min respectively,the blood loss was 15 and 18 ml respectively.The testicular warm-ischemia time was 90 and 70 s respectively.The vein of testes was anastomosed with the inferior epigastric vein,the artery of the testes was anastomosed with the inferior epigastric artery,end-to-end anastomosis of the vas deferens was performed,and finally the scrotum was expandcd by fingers through the incision of the groin,and the testes pushed into the scrotum.After operation the donors and recipients were followed up to observe the recovery.Results Both two cases had successful testicular transplantation and postoperative recovery was satisfactory.Serum testosterone level after operation was significantly higher than before operation (12.8 vs 14.2nmol/L).There was ejaculation phenomenon,but no sperm in the semen.After 3 months,ultrasound examination revealed transplanted testis with good blood supply and the size were morphologically normal.Two donors had mild incision pain after operation,without use of analgesic.On the postoperative day one they could eat,and on the postoperative day two gastrointestinal function was recovered,and they could get out of bed.On the postoperative day three the drainage tubes were removed.On the postoperative day 7,the stitches were removed.One month after the operation,the donors resumed normal life and work. During the period of follow up,there were no specially discomfortable chief complaints and no complications.Conclusion Laparoscopic live related donor orchidectomy can lessen the burden placed on living donor.This approach is available and safe.Successful testicular transplantation can improve the patient's secondary sexual characteristics,and increase the level of serum testosterone. Key words: Laparoscopes; Living donors; Testis; Transplantation