The testicles begin developing in baby boys while they’re still inside their mother’s womb. Normally, the testicles drop down into the scrotum during the last few months before birth. In some cases, however, one or both testicles fail to descend correctly.
In half of these cases, a child’s testicles will drop down into their correct position within the scrotum within the first year of life without treatment. When the testicles don’t descend within the first year, the condition is known cryptorchidism. If your son has cryptorchidism, their doctor will likely recommend surgery to correct it. Undescended testicle repair surgery, also known as orchiopexy or orchidopexy, is an operation that’s commonly done to correct the placement of a testicle that hasn’t dropped into the scrotum. It’s usually performed on boys who are between 5 and 15 months old.
Orchiopexy is performed to correct cryptorchidism, a condition in which one or both testicles haven’t descended into their proper position in the scrotum. If it’s left untreated, cryptorchidism can lead to infertility, increase the risk of testicular cancer, and cause hernias in the groin. It’s important to correct cryptorchidism in your child so that these risks are minimized.
Surgical options may differ for adult males whose undescended testicles weren’t corrected during childhood. Orchiopexy is usually the preferred choice for men who are age 32 and under. However, a doctor may suggest the complete removal of undescended testicles for younger men who are at a high risk of developing cancer. Orchiopexy usually isn’t performed on men over age 32, as there is an increased risk of adverse reactions to anesthesia. If you’re in this situation, consult with your doctor or a urologist to learn more about your options.
Orchiopexy is done under general anesthesia, so certain rules for eating and drinking must be followed in the hours leading up to the procedure. The doctor will give your child specific instructions that they must follow.
While very young children may not realize that they’re going in for surgery, older children may get nervous before their procedure. They might feel especially nervous if you as a parent feel worried. Educate yourself about the procedure so that you feel comfortable and don’t unknowingly project your anxiety onto your son.
Orchiopexy is usually performed 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 shouldn’t be given anything to eat or drink after midnight on the day of the surgery. On the morning of the surgery, you’ll bring your child to the hospital or outpatient clinic.
As the parent, you’ll sign consent forms for the surgery while your child is being prepared in the treatment area. Preparation involves starting intravenous access, or an IV, in a vein in your child’s arm or leg. Your child may feel some mild pain when the IV is inserted, but it’s over quickly.
When it’s time for the surgery to start, an anesthesiologist will inject a general anesthetic into the IV line. This ensures that your child will sleep soundly throughout the procedure.
After your child is asleep, the surgeon will make a small cut into the groin. They’ll then locate the testicle and free the spermatic artery. The spermatic artery holds the testicle in the scrotum. In many cases, a testicle is unable to drop as a result of a short spermatic artery. Freeing the artery from surrounding tissues makes sure that it can be stretched to its full length.
Next, the surgeon will make another small cut in the scrotum, creating a small pouch. The surgeon will then gently draw the testicle down into the scrotum and stitch it securely in place.
Once the procedure is over, the surgeon will close both surgical wounds with sutures or stitches that will eventually dissolve on their own.
Your child will wake up in a recovery room where staff can monitor their vital signs and watch for complications. You’ll likely be able to see and comfort your child while he’s in recovery. Once he’s stable, you can take them home.
Like all surgeries, orchiopexy carries the following risks:
- excessive bleeding
- severe pain
- infection at the surgical incision site
- an adverse reaction to anesthesia
In orchiopexy, there is also a slight risk of the surgeon damaging the testicles or the surrounding tissues. In rare cases, the surgeon may find that the undescended testicle is abnormal or that it has died due to a lack of blood supply. This often requires the surgeon to remove the entire testicle. If both testicles aren’t functioning, the surgeon will refer you to a hormone specialist for additional treatment.
Although this is an outpatient procedure, doctors typically recommend bed rest for at least two to three days.
Once your child is able to get out of bed, he should avoid strenuous activity for at least one month. This will give the scrotum enough time to heal. Activities that may put extra strain on the scrotum, such as riding a tricycle or playing on a rocking horse, are especially discouraged.
Your child’s doctor will want to see them for regular follow-up visits to make sure that the testicle is developing and functioning in the scrotum. As your child gets older, their doctor will teach them how to do a self-examination of their scrotum and testicles. This is very important, as men with a history of undescended testicles have a slightly higher risk of testicular cancer.