Orchidopexy for undescended testicles

An orchidopexy is a common procedure used to treat undescended testicles. This is a condition that is estimated to affect about 1 in every 25 boys.

Here, highly experienced consultant paediatric surgeon, Mr Simon Clarke, provides an expert insight into the procedure and the prognosis of children who have undescended testicles.

What does an orchidopexy involve?

An orchidopexy can either be carried out using keyhole surgery or traditional open surgery. The surgeon will move the testicle down into the scrotum, and the passage will then be closed to stop the testicle moving back into your child's abdomen.
 

The surgeon will find, on occasion, that the testicle has not developed properly or is absent from a previous twist during fetal life. If a healthy testicle is found, then it will be placed in the scrotum and in a position to ensure it doesn't move back into the abdomen, thus developing the normal way. If the testicle is in the abdomen, it can sometimes take two operations to bring the testicle to the correct place in the scrotum.
 

Are there any risks with an orchidopexy surgery?

As with any procedure that uses anaesthetic, it carries the risk of complications, but this is very small. Your child's anaesthetist should be an experienced doctor who is trained to deal with any complications.

As with any surgery, there's a small risk of bleeding or infection. After the operation, there maybe some tenderness in the groin area. Sometimes, there may be some bruising. There is a small chance that a testicle or its blood supply may be affected by the operation of moving it from one part of the body to the scrotum. If the latter were to occur, then the testicle may not grow properly after the procedure. This is a risk with all testicular moving surgery.
 

What happens after the surgery?

Your child will come back to the ward to rest and recover. They will be able to go home once they have had something to eat and drink, and is comfortable. The following day we will follow you to check that your child is ok and is recovering well.
 

For the first 24 hours, your child may feel sick. You should encourage, but not force, your child to drink plenty of fluids. It doesn't matter if he hasn't been eating for the first couple of days, as long as he's drinking plenty of fluids.
 

Pain-relief medications will have been given during the operation, but these will begin to wear off. Your child will need to have regular pain relief tablets for at least two to three days. Ibuprofen and paracetamol are usually sufficient. To help with the recovery process, we recommend distracting your child by playing games, watching TV, or reading together to keep your child's mind off the pain.
 

Your child will probably find that his groin feels sore for a while after the operation. However, wearing loose clothes can help. The stitches used during the operation will dissolve on their own after about 3 weeks, and there is no need to have them removed.
 

Keeping the area where the incision was made clean and dry is advised - it's important for the first two to three days whilst it heals - unless there is a waterproof dressing, in which case, showering the next day is fine. Your child should not ride a bicycle for a couple of weeks after the operation, as this may be uncomfortable.
 

Your child should be able to go back to school within a three to four days, but should avoid contact sports for two weeks.
 

You and your child will need to go back to the hospital for an outpatient appointment about three to six months after the operation. We would send you the appointment date in the post.
 

You should call my secretary or me if:
 

• Your child is struggling to drink any fluids after the first day back home.
• Your child is in a lot of pain, and pain relief medication isn't helping.
• The operation site is inflamed or red and feels hotter than the surrounding skin.
• There is oozing from the operation incision/scar.
   

What is the prognosis for children with undescended testicles?

When undescended testicles are treated in early childhood, the outlook is usually good. Your child can expect normal fertility levels unless there were problems with the testicles themselves. If a damaged testicle was removed, you shouldn't worry about your child become infertile in later life as this usually won't affect their fertility.

If your child is in need of treatment for undescended testicles, don't hesitate to book an appointment with highly experienced consultant paediatric surgeon, Mr Simon Clarke.