Undescended testicle surgery (orchiopexy) is performed in children. The surgeon brings the testicle that has not descended into the scrotum down and secures it in its normal position, aiming to improve its position, ease follow-up and reduce related complications. The doctor decides the timing, usually in the first months or years of life.
In the open approach, the surgeon makes a small incision in the groin and another in the scrotum, frees the testicle and spermatic cord, repairs any accompanying hernia and secures the testicle in the scrotum. If it cannot be felt in the groin, laparoscopy may help locate and free it, sometimes in two stages. General anesthesia is used, often with added local anesthesia.
The operation usually takes about 30 minutes to an hour, and the child often goes home the same day. Running, rough play and strenuous activity are avoided for several weeks, then normal life resumes gradually. The testicle's position and growth are checked at regular follow-up visits set by the doctor.
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It places the testicle where it can be examined and monitored easily, may improve its growth, treats an accompanying hernia if present, and reduces some risks linked to a testicle that stays outside the scrotum. The doctor explains the expected benefits in each case.
When the testicle does not descend into the scrotum on its own, since descent is rarely expected after the first months of life. The doctor decides the right timing after an examination, and imaging tests may come first.
The child fasts for some hours before anesthesia as instructed, and tests and an anesthesia assessment are done when needed. Tell the doctor about all of your child's medicines, and do not stop any of them unless the doctor says so.
Under general anesthesia, the surgeon frees the testicle and spermatic cord through a small groin incision and secures the testicle in a pouch inside the scrotum. In some cases laparoscopy is used to locate and free it, and the testicle is brought down in one or two stages.
The child usually goes home the same day with suitable pain relief, and mild swelling or bruising of the scrotum may appear. Running, rough play and cycling are avoided for several weeks, depending on the doctor's judgment.
The new position of the testicle is clear right after surgery, and follow-up visits over months and years confirm that it stays there and grows. The hope is that it remains in the scrotum, although in some cases it may rise again.
Bleeding, infection or swelling may occur, the testicle may rise again, and in a few cases it may shrink because of reduced blood supply. There is a rare risk of injury to the spermatic cord, which the doctor explains before surgery.
The open approach leaves a small scar in the groin and another in the scrotum, and scars are smaller with laparoscopy. Scars usually fade with time.
Usually after about 3 to 7 days, to make sure the wound is fine, the child is coping and pain is controlled. The treating doctor confirms the suitable time.
A testicle that stays outside the scrotum may affect fertility later, and surgery aims to improve its conditions. Even so, the future outcome cannot be guaranteed in any individual case. The doctor discusses this and sets the follow-up needed.
