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(Orchidopexy—Open Surgery)

Definition

Orchiopexy is surgery to lower the testicles into the scrotum. Testicles should move down from the belly into the scrotum before birth. Some boys are born with one or both testicles still inside the belly or groin. This is called undescended testicles.

Undescended testes
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Reasons for Procedure

Undescended tests can cause problems later in life, such as infertility and testicular cancer. This surgery is done to put the testicle in its normal position.

Possible Complications

Problems are rare, but all procedures have some risk. The doctor will go over some problems that could happen, such as:

  • Excess bleeding
  • Problems from anesthesia, such as wheezing or sore throat
  • Infection
  • Blood clots
  • Injury to nearby structures
  • Damage to testicle
  • Testicle moves back into the groin

What to Expect

Prior to Procedure

The surgical team may meet with you to talk about:

  • Anesthesia options
  • Any allergies your child may have
  • Current medicines, herbs, and supplements that you give your child and whether you need to stop giving them before surgery
  • Fasting before surgery, such as avoiding food or drink after midnight the night before

Anesthesia

General anesthesia will be used. Your child will be asleep.

Description of the Procedure

The doctor will make a small incision in one or both sides of the groin. The testicle is then pulled into a pouch made in the scrotum. It will be held in place with stitches. The incision will also be closed with stitches.

In some children, a button is placed on the outside of the scrotum. It will be used to hold the testicle down until the area heals.

How Long Will It Take?

About 1 hour per testicle

How Much Will It Hurt?

Pain and swelling is common in the first 1 to 2 weeks. Medicine and home care can help.

Average Hospital Stay

Most children can go home the same day. If your child has problems, they may need to stay longer.

Post-procedure Care

At the Hospital

Right after the procedure, the staff may:

  • Give your child pain medicine
  • Teach you how to care for the incisions

During your stay, the hospital staff will take steps to lower your risk of infection, such as:

  • Washing their hands
  • Wearing gloves or masks
  • Keeping your incisions covered

There are also steps you can take to lower your risk of infection, such as:

  • Washing your hands often and reminding visitors and staff to do the same
  • Reminding staff to wear gloves or masks
  • Not letting others touch your incisions
At Home

It will take about 2 weeks to recover. Physical activity will be limited during this time.

Call Your Child’s Doctor

Call the doctor if your child is not getting better or has:

  • Signs of infection, such as fever or chills
  • Redness, swelling, excess bleeding, or discharge from the incisions
  • Nausea or vomiting
  • Pain that cannot be controlled with medicine
  • Changes in frequency, odor, appearance, or amount of urine
  • Problems urinating
  • Tiredness
  • Loss of hunger

If you think your child has an emergency, call for medical help right away.

RESOURCES

Family Doctor—American Academy of Family Physicians  https://familydoctor.org 

Healthy Children—American Academy of Pediatrics  https://www.healthychildren.org 

CANADIAN RESOURCES

Caring for Kids—Canadian Pediatric Society  https://www.caringforkids.cps.ca 

Health Canada  https://www.canada.ca 

References

Cryptorchidism. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/cryptorchidism. Accessed December 14, 2020.

Orchiopexy: Surgery for undescended testicles. About Kids Health—The Hospital for Sick Children website. Available at: https://www.aboutkidshealth.ca/Article?contentid=1010&language=English. Accessed December 14, 2020.

Tekgul S, Dogan HS, et al; European Society for Paediatric Urology and European Association of Urology (ESPU/EAU). Guidelines on paediatric urology. EAU 2017 Mar.

Undescended testicle surgery (orchiopexy). Children’s Hospital of Philadelphia website. Available at: https://www.chop.edu/treatments/surgery-undescended-testicles-orchiopexy#.VZBqk010xMs. Accessed December 14, 2020.

Revision Information

  • Reviewer: EBSCO Medical Review Board Marcin Chwistek, MD
  • Review Date: 09/2020
  • Update Date: 04/23/2021