Repair of undescended testicle

Alternative names
Orchidopexy; Inguinal orchidopexy; Orchiopexy; Undescended testicle repair; Cryptorchidism repair

Definition

Undescended testicle repair is surgery to correct undescended testes (cryptorchism).

In normal fetal development, the testicles develop in the abdomen and descend into the scrotum during the last months before birth. In 3.4% of newborns, however, 1 or both testicles do not descend into the scrotum. About half of these cases will descend within the first year of life without medical attention. This surgery is recommended for patients whose testicles do not descend on their own.

Description

While the child is unconscious and pain-free under general anesthesia, an incision is made in the groin, where most undescended testes are lodged. The spermatic cord is located and freed from surrounding tissues to maximize its length. A small incision is made in the scrotum and a pouch is created. The testicle is carefully pulled down into the scrotum. The testicle is stitched in place in the scrotum and the incisions are stitched closed.

Indications

Undescended testicles often descend into the scrotum by 1 year of age. It is unusual, however, for testicles to descend on their own after the age of 1 year. This surgery is recommended for infants older than 1 year whose testicles have not descended into the scrotum (cryptorchidism).

This condition is more common in premature babies. Most often, only 1 side is affected.

Undescended testicles may cause infertility and are more prone to developing malignant tumors in later years.

Risks
Risks for any anesthesia are:

     
  • Reactions to medications  
  • Problems breathing

Risks for any surgery are:

     
  • Bleeding  
  • Infection

Expectations after surgery

Undescended testicle repair is successful in most cases. The long-term prognosis for hormone production and fertility is excellent. A small percentage (10%) of individuals will have fertility problems, however.

Men who have had undescended testicles should be examined monthly, throughout their lives, to detect any possible tumor development. Individuals with undescended testes have a 30- to 50-fold higher rate of Testicular cancer than those with normal testicular development.

Convalescence
The surgery may be done on an outpatient basis. Bed rest is recommended for the first 2 to 3 days. Strenuous activity, including bicycling, should be avoided for at least 1 month to allow rehabilitation of the testis in its new position.

Johns Hopkins patient information

Last revised: December 6, 2012
by Simon D. Mitin, M.D.

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