Undescended Testicle Repair
Undescended testicle repair is also known as orchiopexy. It’s an operation that corrects the placement of a testicle that has not dropped from the groin (inside the body) to the scrotum.
Some undescended testicles move into the correct position within the child’s first year. However, surgery is usually needed. Orchiopexy is usually performed on boys between the ages of six months and 15 months (Mayo Clinic, 2010).
What Happens During Undescended Testicle Repair Surgery?
Undescended testicle repair is done on an outpatient basis. This means the patient is not admitted to the hospital or kept overnight. Your child should not be given anything to eat or drink after midnight on the day of the surgery. On the morning of the surgery, you will bring the child to the hospital or day surgery center.
As the parent, you will sign consent forms for the surgery while your child is being prepared in the treatment area. Preparation involves starting an IV in a vein in the child’s arm or leg. This will likely cause some pain, but it is over quickly.
When it is time for the surgery to start, an anesthesiologist injects a general anesthetic into the IV line. This ensures that the child will sleep soundly throughout the procedure.
After the child is asleep, the surgeon makes a small incision (cut) into the groin. He or she will locate the testicle and free the spermatic artery. The spermatic artery holds the testicle in the scrotum. One common reason for an undescended testicle is that the spermatic artery is shorter than normal. Freeing the artery from surrounding tissues makes sure that it can be stretched to its full length.
Next, the surgeon makes another small cut in the scrotum which creates a small pouch. The surgeon draws the testicle down into the scrotum, stitches it securely in place, and closes the surgical wound.
Your child will wake up in a recovery room where staff can monitor his vital signs and watch for complications like heavy bleeding and pain. You will likely be able to see and comfort your child while he is in recovery. Once he is stable, you can take him home.
Risks and Complications
Any time a patient is given general anesthesia, there is a small risk of an allergic reaction that interferes with breathing. Additionally, all surgeries carry the standard risks of excessive bleeding, pain, and infection.
In orchiopexy, there is a slight risk of the surgeon damaging the testicles or the surrounding tissues.
A small percentage of men who have gone through this procedure report having fertility problems later in life.
Occasionally, the surgeon will find that the undescended testicle is abnormal or that it has died due to a lack of blood supply. In these cases, the surgeon removes the testicle. If both testicles are non-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 two or three days.
Once the child is able to get out of bed, he should avoid strenuous activity for a month to give the scrotum a chance to heal. Activities like riding a tricycle or a rocking horse may put extra strain on the scrotum and are especially discouraged.
Doctors will want to see the child for regular follow-up visits to make sure that the testicle is developing and functioning in the scrotum. As the child gets older, doctors will teach him how to self-examine his scrotum and testicles. This is important, because men who have had an undescended testicle have a slightly higher risk of testicular cancer than those who have never had this problem (APSA, 2003).