Orchiopexy for Undescended Testicle

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) does the surgery.

Orchiopexy may also be done on older boys. In rare cases, it may be done 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. This allows the surgeon to reach the testicle and move it to the scrotum. Sometimes another type of surgery called laparoscopy is used to move undescended testicles. It may be done 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 in the abdomen, orchiopexy may require two separate operations that are done several months apart.

What To Expect

This 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 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, your child 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 surgery.

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Why It Is Done

The surgery (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 this surgery 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 who need it.^{footnote 2}

Risks

Possible complications include:

• Infection.
• Bleeding or blood clots in the scrotum.
• Damage to the vas deferens and the blood supply to the testicle. Without enough blood supply, the testicle may shrink (atrophy).
• The testicle(s) moving out of the scrotum again (reascend) after surgery and needing more treatment. This is rare.