The testicles begin developing in male babies before they’re born, and normally 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 about 80 percent of these cases, a child’s testicles will drop down into their correct position within the scrotum by the third month after birth without requiring treatment.

When the testicles don’t descend within the first few months, the condition is known as cryptorchidism. A doctor will likely recommend surgery to correct the placement of the testicle that hasn’t dropped into the scrotum.

This procedure is called orchiopexy or orchidopexy. Such repairs should ideally happen between six months and one year after birth, according to a systematic review.

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 and can increase the risk of testicular cancer. Undescended testicles are also associated with hernias in the groin.

It’s important to correct cryptorchidism in your child in order to minimize the risks.

For adult males whose undescended testicles weren’t corrected during childhood, surgical options may vary.

In such cases, the testicular tissue may not be functional, and it may come with a higher risk of testicular cancer. Therefore, your doctor may recommend the complete removal of undescended testicles. This is called an orchiectomy.

Orchiopexy is done under general anesthesia, which includes certain rules for eating and drinking in the hours leading up to the procedure. Your doctor will provide specific instructions to follow.

While 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, so it’s wise to educate yourself about the procedure beforehand so that you feel comfortable.

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.

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. They may feel some mild pain when the IV is inserted, but it’s over quickly. In some cases, your child may be put to sleep before an IV is inserted.

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.

Once your child is asleep, the surgeon will make a small cut in the groin. They’ll then locate the testicle, which tethers to the scrotum by a piece of tissue called the gubernaculum.

The surgeon may make small cuts to adjust both the gubernaculum and possibly another piece called the spermatic cord.

The testicle is tethered to the body by the spermatic cord, which is made up of blood vessels and the vas deferens, and is surrounded by a muscle called a cremaster. By freeing the cord from its surrounding attachments, the surgeon gains length needed to reach the scrotum.

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 this is done, 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 at this stage. Once they’re 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 damage to 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 removal of the entire testicle.

If neither testicle is functioning, the surgeon will refer you to a hormone specialist for additional treatment.

Although this is an outpatient procedure, your surgeon may advise less activity or possibly bed rest for a few days afterward.

Your child may need to avoid strenuous activity for at least a month so the scrotum has 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 schedule 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 important, as a history of undescended testicles comes with a slightly higher risk of testicular cancer.