Surgery Overview
Surgery to move an undescended testicle into the scrotum is called orchiopexy or orchidopexy. Surgery is usually recommended by the time the baby is 18 months old.footnote 1 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 examination 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 2
- 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 2
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.
References
Citations
- Luis LH, et al. (2017). Canadian Urological Association-Pediatric Urologists of Canada (CUA-PUC) guideline for the diagnosis, management, and followup of cryptorchidism. Canadian Urological Association Journal, 11(7): E251–E260. DOI: 10.5489/cuaj.4585. Accessed February 26, 2018.
- 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
Current as of: June 29, 2020
Author: Healthwise Staff
Medical Review: John Pope MD - Pediatrics
Anne C. Poinier MD - Internal Medicine
Adam Husney MD - Family Medicine
E. Gregory Thompson MD - Internal Medicine
Peter Anderson MD, FRCS(C) - Pediatric Urology
