The testicles begin to develop in the baby while still inside their mother’s uterus.
Usually, the testicles descend into the scrotum during the last months before birth. However, one or both testicles do not descend correctly in some cases.
In half of these cases, a child’s testicles will fall into their correct position within the scrotum within the first year of life without treatment. When the testicles do not descend within the first year, the condition of cryptorchidism is known.
If your child has cryptorchidism, your doctor will probably recommend surgery to correct it.
The orchidopexy, also known as repair surgery undescended testis, is commonly performed to correct the placement of one testicle that has not fallen into the scrotum.
It is usually done in children between 5 and 15 months old.
Why is an undescended testicle repair performed?
Orchidopexy is performed to correct cryptorchidism, a condition in which one or both testicles have not descended to their correct position in the scrotum.
If left untreated, the cryptorchidism can cause infertility, increase the risk of testicular cancer and cause hernias in the groin. It is essential to correct the cryptorchidism in your child to minimize these risks.
Surgical options may differ for adult men whose undescended testes were not corrected during childhood. Orchidopexy is usually the preferred option for men aged 32 or younger.
However, a doctor may suggest the complete removal of undescended testes for younger men at high risk of developing cancer.
Orchidopexy is not usually performed in men older than 32 years, as there is a greater risk of adverse reactions to anesthesia. If you are in this situation, ask your doctor or a urologist for more information about your options.
How do I prepare for an orchidopexy?
Orchidopexy is performed under general anesthesia, so specific rules about eating and drinking should be followed in the hours before the procedure. The doctor will give your child clear instructions to follow.
While very young children may not realize they will have surgery, older children may get nervous before their procedure.
As a parent, you may feel incredibly nervous if you feel worried. Find out about the procedure to feel comfortable and not inadvertently project your anxiety into your child.
What happens during an orchidopexy?
Orchidopexy is usually done on an outpatient basis, which means that your child can go home the same day as the procedure.
However, your child may need to stay in the hospital overnight if complications arise during the procedure.
Your child should not be given anything to eat or drink after midnight on the day of surgery. On the morning of surgery, you will take your child to the hospital or outpatient clinic.
As a parent, you will sign consent forms for surgery while your child is preparing in the treatment area. Preparation involves starting intravenous access, or IV, into a vein in your child’s arm or leg.
Your child may feel mild pain when the intravenous line is inserted, but the pain quickly ends.
An anesthesiologist will inject general anesthesia into the intravenous line when the time comes to begin surgery. This ensures that your child sleeps deeply during the procedure.
After your child is asleep, the surgeon will make a small cut in the groin. Next, they will locate the testicle and release the spermatic artery. The spermatic street supports the testicle in the scrotum.
In many cases, a testicle can not fall due to a short spermatic artery. Releasing the street from the surrounding tissues ensures that it can stretch its entire length.
Then, the surgeon will make another small cut in the scrotum, creating a small bag. Then, the surgeon will gently place the testicle in the scrotum and sew it securely in place.
Once the procedure is completed, the surgeon will close both surgical wounds with sutures or stitches that eventually dissolve independently.
Your child will wake up in a recovery room where staff can monitor their vital signs and see if there are complications. You can probably see and comfort your child while he is in recovery. Once you are stable, you can take them home.
What are the risks of an orchidopexy?
Like all surgeries, orchiopexy carries the following risks:
- Excessive bleeding
- Severe pain
- Infection at the site of the surgical incision.
- Adverse reaction to anesthesia.
There is also a slight risk that the surgeon will damage the testicles or the surrounding tissues in orchiopexy. In rare cases, the surgeon may find that the undescended testicle is abnormal or has died due to a lack of blood supply.
This often requires the surgeon to remove the entire testicle. If both testicles are not working, the surgeon will refer you to a hormone specialist for further treatment.
What happens after the surgery?
Although orchidopexy is an outpatient procedure, doctors usually recommend bed rest for at least two or three days.
Once your child can get out of bed, you should avoid strenuous activity for at least a month. This will give the scrotum enough time to heal.
Activities that may exert additional pressure on the scrotum, such as riding a tricycle or playing on a rocking horse, are discouraged.
Your child’s doctor will want to see you for regular follow-up visits to ensure the testicle develops and functions in the scrotum.
Your doctor will show you how to self-examine the scrotum and testicles as your child gets older. This is very important since men with a history of orchidopexy have a slightly higher risk of testicular cancer.