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Orchiopexy—Open Surgery

(Orchidopexy—Open Surgery)

Pronounced: or-kee-o-pecks-ee
En Español (Spanish Version)

Definition | Reasons for Procedure | Possible Complications | What to Expect | Call Your Child’s Doctor

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

Complications are rare, but no procedure is completely free of risk. Your doctor will review a list of possible complications, which may include:

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

Talk to your doctor about these risks before the surgery.

What to Expect

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.

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

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.

One hour per testicle

Pain or soreness after the procedure will be managed with pain medications.

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

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

After leaving the hospital, contact the doctor if any of the following occurs:

  • 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
  • Vomiting
  • Abdominal pain
  • Lack of energy
  • Loss of appetite

In case of an emergency, call for medical help right away.

RESOURCES:

American Academy of Family Physicians

http://familydoctor.org

American Academy of Pediatrics

http://www.healthychildren.org

CANADIAN RESOURCES:

Canadian Pediatric Society

http://www.cps.ca

References:

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.chp.edu/cs/Satellite?c=eHA_Content_C&cid=1209404825839&pagename=CHP/eHA_Content_C/CHP/Template/CHP_Layout_04_Content_Page_Template. Updated April 7. Updated November 2008. Accessed July 23, 2013.

6/6/2011 DynaMed's Systematic Literature Surveillance 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.

Last reviewed July 2013 by Marcin Chwistek, MD; Michael Woods, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.