What Is an Undescended Testicle Repair?
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.
Why Is an Undescended Testicle Repair Performed?
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.
How Do I Prepare for an Undescended Testicle Repair?
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.
What Happens During an Undescended Testicle Repair?
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.
What Are the Risks of an Undescended Testicle
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.
What Happens After an Undescended Testicle Repair?
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