Surgery Overview
Surgery to move an
undescended testicle into the
scrotum is called orchiopexy or orchidopexy. It is
usually performed on babies who are 9 to 15 months old. In most cases, a
pediatric
surgeon or a specialist who treats urinary problems in
children (pediatric
urologist) performs the surgery.
Orchiopexy may also be done on older boys and, rarely, on teens and adult
men who have undescended testicles.
Depending on the
location of the testicle, one or two small incisions are made in the scrotum,
the
groin, or the abdomen to allow the surgeon to reach
the testicle and move it to the scrotum. Sometimes another surgical method
called
laparoscopy is used to move undescended testicles when
they are located high in the
inguinal canal or in the abdomen. In both types of
orchiopexy,
general anesthesia is used.
Usually only
one surgery is needed. But in some cases where the testicles are located in the
abdomen, orchiopexy may require two separate operations that are done several
months apart.
What To Expect After Surgery
Orchiopexy can be done as an outpatient
procedure if it is uncomplicated. Sometimes a child needs a short hospital stay. The surgery for testicles that are
located just above the scrotum and for testicles that are low in the inguinal
canal is usually much simpler than for testicles that are higher up in the
canal or in the abdomen.
For
at least 2 weeks after surgery, boys should avoid games, sports, rough play,
bike riding, and other activities where there is a risk of an injury to the
genitals.
The doctor will do a follow-up exam usually within
2 to 3 months after the operation.
Why It Is Done
Orchiopexy is done to place an
undescended testicle in its normal position in the
scrotum.
- Placing undescended testicles in the scrotum
may help prevent
infertility and may reduce the risk of testicular cancer.footnote 1
- Treatment makes it easier to find
testicular cancer if this cancer occurs.
- Surgery can boost a boy's self-esteem. An
empty or partially empty scrotum can make a boy feel bad about himself and his
body, especially during the teen years.
- This surgery helps lower the risk of injury to the testicle. If the testicles are in the groin area, a boy has a higher risk for sports injuries and discomfort from seat belts.
How Well It Works
Usually the outcome of orchiopexy is
good, and the testicle is moved into the scrotum. But success rates vary by
where the testicle is located at the time the surgery is done. In general, this
treatment works well in almost all of the
males who need it.footnote 1
Risks
Possible complications from orchiopexy include:
- Infection.
- Bleeding or blood clots
in the scrotum.
- Damage to the
vas deferens and the blood supply to the testicle.
Without an adequate blood supply, the testicle may shrink (atrophy).
- The testicle(s) moving out of the scrotum again (reascend) after
surgery and requiring further treatment. This is rare.
What To Think About
Orchiopexy is considered a safe and
reliable procedure that has relatively few risks. It is best to choose a
surgeon and hospital staff who have training and experience in this procedure
and in the special needs of children.
Some doctors recommend a testicular
biopsy during orchiopexy if the undescended testicle
is in the abdomen or if the child has genital defects, such as
hypospadias, or a
genetic disorder. In this test, a small sample of
tissue is taken from the testicles and then examined.
Complete the surgery information form (PDF)(What is a PDF document?) to help you prepare for this surgery.
References
Citations
- Elder JS (2011). Disorders and anomalies of the scrotal contents. In RM Kliegman et al., eds., Nelson Textbook of Pediatrics, 19th ed., pp. 1858-1864. Philadelphia: Saunders.
Credits
ByHealthwise Staff
Primary Medical ReviewerJohn Pope, MD - Pediatrics
Specialist Medical ReviewerPeter Anderson, MD, FRCS(C) - Pediatric Urology
Elder JS (2011). Disorders and anomalies of the scrotal contents. In RM Kliegman et al., eds., Nelson Textbook of Pediatrics, 19th ed., pp. 1858-1864. Philadelphia: Saunders.