What is an orchidopexy?
The operation to bring an undescended testicle down into the scrotum is called an orchidopexy. Before birth, the testicle grows inside the baby’s tummy and moves down into the scrotum during late pregnancy. In about 1 in every 100 boys the testicle does not complete this journey and gets held up in the groin. Usually only one testicle is affected but sometimes both are undescended.
Why is an orchidopexy necessary?
Orchidopexy is recommended for several reasons:
- to maximise the ability of the testicle to make sperm and contribute to fertility in the future
- because boys like to look and feel like other boys
- to reduce the risk of a cancer developing in the testicle in adult life. Cancer of the testicle is rare but is more common in an undescended testicle. Bringing the testicle down decreases the chance of a cancer developing and makes it easier to detect.
Is there any alternative to surgery?
A testicle may still descend in the first few months of life, particularly in premature babies. After six months of age, further natural descent is very unlikely. Surgery is then the only way to get the testicle into the scrotum.
What does the operation involve?
The operation is done under a general anaesthetic and takes about 30-40 minutes. Your child will be in the operating theatre for longer because it takes time to safely put him to ‘sleep’ and wake him up from the anaesthetic. Once your child is asleep the surgeon makes a small cut in the groin and finds the undescended testicle, which is freed up along with its blood vessels and the tube that transmits sperm from the testicle (the vas). A small incision is made in the scrotum and the testicle is brought down into the scrotum where it may be stitched in place. The skin wounds are closed with dissolving stitches and a clear plastic dressing put on the groin wound. A local anaesthetic injection is frequently given during the operation to reduce discomfort after surgery. After the operation your child will be transferred to the recovery room where you can join him.
Occasionally, during surgery the testicle is found to be very small and abnormal. In these cases it may be removed as it is unlikely to contribute any worthwhile function and may be more at risk of developing a cancer in later life.
An orchidopexy is a common and usually straightforward operation but any operation has a risk of complications. These include:
- Complications of the anaesthetic. Your anaesthetist is the best person to discuss these.
General complications of any operation. Bruising around the wound or in the scrotum and infection in the wound are
- uncommon. You should consult your family doctor if the wound becomes red or increasingly painful.
- Rare complications of the operation:
- The testicle fails to remain in the scrotum and retracts back to the groin. This is more likely if the blood vessels going to the testicle are particularly short. A further operation may then be needed to bring it down into the scrotum.
- Damage to the structures around the testis. Damage to nerves can cause temporary numbness in an area of groin skin. Damage to the testicular blood vessels or the sperm tube (vas) can cause the testicle to shrink and disappear. Future fertility would then depend on whether the other testicle works normally.
When will my child be able to go home after the operation?
The operation is usually carried out as ‘day surgery’ so your child should be able to go home later the same day. You will be advised to give him regular doses of a painkiller such as Paracetamol during the first 24 hours after the operation.
When can my child resume normal activities?
Boys recover quickly after an orchidopexy. They can have a quick bath or shower the next day. The plastic dressing on the groin can be removed if it is still there after a week. Older children can usually get back to school after a few days and return to sports about 2-3 weeks after the operation. The general rule is “if it hurts, stop and wait a bit longer before trying again”.