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Orchiopexy -- Open Surgery

Definition

Sometimes baby boys are born with one or both testicles inside the abdomen or groin, rather than in the scrotum. This is called undescended testicles . Orchiopexy is a surgery to lower the testicles into the scrotum. The scrotum is the external sac that holds the testicles.

Undescended testes
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Reasons for Procedure

The procedure is used to treat undescended testicles that do not move down on their own.

Possible Complications

Problems from the procedure are rare, but all procedures have some risk. Your child's doctor will review potential problems, like:

  • Testicle moves back up into groin again after surgery
  • Damage to the testicle
  • Bleeding
  • Infection
  • Reaction to anesthesia
  • Injury to surrounding structures

What to Expect

Prior to Procedure

Your child’s doctor and anesthesiologist will do the following:

  • Examine your child
  • Do imaging, blood, and urine tests
  • Discuss the anesthesia being used and the potential risks
  • Discuss the risks of surgery and answer any questions you have

Talk to the doctor about your child’s medications or any recent illnesses. You may be asked to have your child stop or start certain medications before surgery.

Other things to keep in mind before the procedure include:

  • Bring special toys, books, and comfortable clothing for your child.
  • Your child will need to avoid eating for a period of time before surgery. Ask the doctor when your child should stop eating and drinking. For children less than one year, it is often recommended that they do not eat after midnight the night before the surgery. Clear liquids such as breast milk, water, and clear juices may be allowed up to two hours before the procedure.

Anesthesia

General anesthesia will be used. Your child will be asleep during the surgery. He will not feel any pain.

Description of the Procedure

After your child is asleep, the doctor will make a small incision in one or both sides of the groin. The testicle is located and examined. If there is a hernia present, the doctor will also repair this.

Next, the doctor will create a pouch in the scrotum. The testicle will be pulled down into this new pouch. Stitches will hold the testicles in place. The stitches will dissolve on their own. All other incisions will be closed with stitches.

In some cases, a small button will be placed on the outside of the scrotum and secured with a suture. This will hold the testicle down until healing occurs. The button will be removed by cutting the suture a few weeks after the procedure.

In most cases, your child can go home on the same day as the surgery.

How Long Will It Take?

One hour per testicle

How Much Will It Hurt?

Anesthesia prevents pain during surgery. Your child will be given medication to relieve pain or soreness during recovery.

Post-procedure Care

At the Care Center
  • Your child will be monitored while he recovers from the anesthesia.
  • The nurse will give pain medicine as needed.
Preventing Infection

During your child's stay, the care center staff will also take steps to reduce the chance of infection, such as:

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

There are also steps you can take to reduce your child's chance of infection, such as:

  • Washing both you and your child's hands often, and reminding visitors and healthcare providers to do the same
  • Reminding your child's healthcare providers to wear gloves or masks
  • Not allowing others to touch your child's incision
At Home

When your child returns home, you may need to do the following to help ensure a smooth recovery:

  • Give medications as directed to treat pain and prevent infection.
  • Minor bleeding is normal. Care for the incisions as directed.
  • Change your child’s diaper often. Leave it off for short periods to allow air at the incision sites.
  • Ask your doctor about when it is safe to bathe your child.
  • Engage in gentle play. Avoid tiring activities for a few weeks. Sitting on or riding a bicycle should be avoided for about a week after the surgery.
  • Monitor your child for signs of pain. Examples include fussiness, trouble moving, sweating, and pale skin.
  • Be sure to follow the doctor’s instructions.

Call Your Child’s Doctor

Call your child's doctor if any of these occur:

  • Increasing pressure or pain
  • Redness, drainage, puffiness, or soreness around the incision site
  • Changes in the frequency, odor, appearance, or volume of urine
  • Difficulty urinating
  • Signs of infection, including fever or chills
  • Persistent nausea and/or vomiting
  • Abdominal pain
  • Lack of energy
  • Loss of appetite

If you think you have an emergency, call for medical help right away.

Revision Information

  • Family Doctor—American Academy of Family Physicians

    http://familydoctor.org

  • Healthy Children—American Academy of Pediatrics

    http://www.healthychildren.org

  • Canadian Pediatric Society

    http://www.cps.ca

  • Health Canada

    http://www.hc-sc.gc.ca

  • About Kids Health. Orchiopexy: surgery for undescended testicles. About Kids Health website. Available at: http://www.aboutkidshealth.ca/En/HealthAZ/TestsAndTreatments/Procedures/Pages/Orchidopexy-Surgery-for-Undescended-Testicles.aspx. Updated November 10, 2009. Accessed July 23, 2013.

  • Elyas R, Guerra LA, Pike J, et al. Is staging beneficial for Fowler-Stephens orchiopexy? A systematic review. J Urol. 2010;183(5):2012-2018.

  • Orchiopexy. Children’s Hospital and Clinics of Minnesota website. Available at: http://www.childrensmn.org/Manuals/PFS/Surg/018757.pdf. Updated March 2009. Accessed July 23, 2013.

  • Undescended testicles. Children’s Hospital of Pittsburgh website. Available at: http://www.chop.edu/service/surgery-general-thoracic-and-fetal/conditions-we-treat/pediatric-surgery-undescended-testicles.html. Updated November 2008. Accessed July 23, 2013.

  • 6/6/2011 DynaMed's Systematic Literature Surveillance Available at: http://www.ebscohost.com/dynamed: Mills E, Eyawo O, Lockhart I, Kelly S, Wu P, Ebbert JO. Smoking cessation reduces postoperative complications: a systematic review and meta-analysis. Am J Med. 2011;124(2):144-154.e8.