Orchiopexy

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. 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.

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.
• 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.

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.

Surgery can be stressful. This information will help you understand what you can expect. And it will help you safely prepare for surgery.

Preparing for surgery

• Be sure you have someone to take you home. Anesthesia and pain medicine will make it unsafe for you to drive or get home on your own.
• Understand exactly what surgery is planned, along with the risks, benefits, and other options.
• If you take a medicine that prevents blood clots, your doctor may tell you to stop taking it before your surgery. Or your doctor may tell you to keep taking it. (These medicines include aspirin and other blood thinners.) Make sure that you understand exactly what your doctor wants you to do.
• Tell your doctor ALL the medicines, vitamins, supplements, and herbal remedies you take. Some may increase the risk of problems during your surgery. Your doctor will tell you if you should stop taking any of them before the surgery and how soon to do it.
• Make sure your doctor and the hospital have a copy of your advance directive. If you don’t have one, you may want to prepare one. It lets others know your health care wishes. It’s a good thing to have before any type of surgery or procedure.

Activity

• Let your child rest in bed for a few days. Sleeping will help him recover.
• Have your baby or toddler avoid doing any tumbling for a few days. Have your child avoid doing straddling activities, such as riding a tricycle or using a sit-on toy, for 3 to 4 weeks.
• Do not let your child do intense exercise, such as sports, running, or physical education at school, for 4 to 6 weeks.
• Your child may shower or have a sponge bath the day after surgery. Do not let him swim or have a bath for 5 to 7 days.
• Your child should be able to go back to school or day care in 2 or 3 days.

Diet

• Have your child drink plenty of fluids for the first 24 hours to avoid becoming dehydrated. Use clear fluids, such as water, apple juice, and flavored ice pops. Avoid hot drinks, soda pop, and citrus juices such as orange juice. These may cause more pain.
• When your child is ready to eat, start with foods that are easy to swallow. These include soft noodles, pudding, and dairy foods such as yogurt and ice cream. Canned or cooked fruit, scrambled eggs, and mashed potatoes are also good choices. Avoid giving your child steamy, hot, spicy, or hard and crunchy foods, such as chips or waffles.
• You may notice a change in your child's bowel habits right after surgery. This is common. If your child has not had a bowel movement after a couple of days, call your doctor.

Medicines

• Your doctor will tell you if and when your child can restart his or her medicines. The doctor will also give you instructions about your child taking any new medicines.
• Have your child take medicines exactly as prescribed. Call your doctor if you think your child is having a problem with his medicine.
  • If the doctor gave your child a prescription medicine for pain, see that your child takes it as prescribed.
  • If your child is not taking a prescription pain medicine, ask your doctor if you can give him an over-the-counter medicine.
• If you think the pain medicine is making your child sick to his stomach:
  • Give him medicine after meals (unless your doctor has told you not to).
  • Ask your doctor for a different pain medicine.
• If your doctor prescribed antibiotics, be sure your child takes them as directed. Your child should not stop taking them just because he feels better. Your child needs to take the full course of antibiotics.

Incision care

• Always wash your hands before touching the incision area.
• If your child has strips of tape on the incision, leave the tape on for a week or until it falls off.
• Wash the area daily with warm, soapy water and pat it dry. Don't use hydrogen peroxide or alcohol, which can slow healing. You may cover the area with a gauze bandage if it weeps or rubs against clothing. Change the bandage every day.
• Keep the area clean and dry.