What is an Orchiopexy

Orchiopexy is a procedure to position a testicle in the scrotum. It is done if a child is born with one or both of his testicles in his abdomen instead of in his scrotum, and the testicles do not drop into the scrotum on their own.

It is often done before a child is 2 years of age, but it can be done later in life instead.

This procedure may be done as an open procedure or as a laparoscopic procedure. If it is done as an open procedure, it will be done through one cut (incision) in the area where the testicle is located and another cut in the scrotum.

If it is done as a laparoscopic procedure, it will be done through tiny incisions in the abdomen.

What are the risks?

Generally, this is a safe procedure. However, problems may occur, including:

• Infection.
• Bleeding.
• Allergic reaction to numbing medicines.
• Damage to nearby nerves, tissues, or structures.
• Blood clots.
• Scarring. Scarring is less likely with a laparoscopic procedure than it is with an open procedure.

What happens before the procedure?

• A physical exam will be done.
• Tests may be done, including blood tests and X-rays.
• Follow instructions from your child’s health care provider about eating or drinking restrictions.
• Ask your child’s health care provider about:
  • Changing or stopping any regular medicines.
  • Giving your child other medicines such as ibuprofen. Do not give these medicines before the procedure your child’s health care provider tells you not to.
• If you are breastfeeding, bring your pumping supplies to the hospital on the day of the procedure.
• Be prepared to help keep your child calm before the procedure. It may help if you bring items to the hospital to comfort your child.
• Ask your child’s health care provider how the surgical site will be marked or identified.
• Your child may be given antibiotic medicine to help prevent infection.

What happens during the procedure?

Open Procedure

• To reduce your child’s risk of infection:
  • Your child’s health care team will wash or sanitize their hands.
  • Your child’s skin will be washed with soap.
• Your child will be given one or more of the following:
  • A medicine to help him relax (sedative).
  • A medicine to numb the area (local anesthetic).
  • A medicine to make him fall asleep (general anesthetic).
• A small incision will be made in the groin or abdomen near the testicle.
• Any bulging tissue around the testicle will be repaired.
• An incision will be made in the scrotum.
• The testicle will be moved into the scrotum.
• The incisions will be closed with stitches (sutures).
• A bandage (dressing) may be placed over the incisions.

Laparoscopic Procedure

• To reduce your child’s risk of infection:
  • His health care team will wash or sanitize their hands.
  • His skin will be washed with soap.
• Your child will be given one or more of the following:
  • A medicine to help him relax (sedative).
  • A medicine to numb the area (local anesthetic).
  • A medicine to make him fall asleep (general anesthetic).
• Three or four incisions will be made in the abdomen.
• A thin, lighted tube (laparoscope) and other medical instruments will be inserted through the incisions.
• The instruments will be used to move the testicle into the scrotum.
• The incisions will be closed with stitches (sutures).
• A bandage (dressing) may be placed over the incisions.

These procedures may vary among health care providers and hospitals.

What happens after the procedure?

• Your child will slowly wake up in the recovery room.
• Your child may be groggy, fussy, or confused. He may feel sick to his stomach and he may vomit.
• When your child feels better, he may be offered a drink or a frozen ice pop.
• Your child’s blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored often until the medicines he was given have worn off.

Contact a health care provider if:

• Any allergies your child has.
• All medicines your child is taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
• Previous problems your child or members of your family have had with the use of anesthetics.
• Any blood disorders your child has.
• Previous surgeries your child has had.
• Any medical conditions your child has.

Care After Orchiopexy

These instructions provide you with information about caring for your child after the procedure. Your child’s health care provider may also give you more specific instructions. The treatment has been planned according to current medical practices, but problems sometimes occur. Call your child’s health care provider if you have any problems or questions after your child’s procedure.

What can I expect after the procedure?

After the procedure, it is common for your child to be:

• Groggy.
• Fussy.
• Confused.
• Nauseous.

Your child may also have a decreased appetite.

Follow these instructions at home:

Eating and drinking

• If your child is breastfeeding or is on formula, feed him as you normally would.
• If your child is older than 12 months and is eating solid foods, follow these instructions:
  • For the first 3–4 hours after the procedure, give your child clear liquids only.
  • After 3–4 hours, you may give your child light foods, such as toast, crackers, applesauce, soup, cereal, bananas, and rice. Do not give your child greasy foods, such as pizza. Do not feed your child if he is not fully alert.
  • For 24 hours after the procedure, offer your child healthy foods only.

Activity

• Have your child rest after coming home on the day of the surgery.
• Your child may return to daycare or school on the day after the surgery or when he feels well.
• Limit your child’s activities for 2–3 days.
• Do not allow your child to ride a bike or swim for 1 week.
• Do not allow your child to play contact sports or do other strenuous activities until your child’s health care provider says that it is okay.

Bathing

• Wash your child using sponge baths for at least 5 days or until the surgical cuts (incisions) have healed.
• Do not allow your child to sit in a tub or a pool for at least 5 days or until the incisions have healed.
• Ask your child’s health care provider if your child can take quick showers after 2–3 days.

Incision care

• Apply ointment to the incisions as told by your child’s health care provider.
• Follow instructions from your child’s health care provider about how to take care of the incisions. It is important to:
  • Wash your hands with soap and water before you change your child’s bandage (dressing). If soap and water are not available, use hand sanitizer.
  • Change your child’s dressing as told by your child’s health care provider.
  • Leave stitches (sutures), skin glue, or adhesive strips in place. In some cases, these skin closures may need to be in place for 2 weeks or longer. If adhesive strip edges start to loosen and curl up, you may trim the loose edges. Do not remove adhesive strips entirely unless your child’s health care provider tells you to remove them.

General instructions

• Give your child over-the-counter and prescription medicines only as told by his health care provider.
• Keep all follow-up visits as told by your child’s health care provider. This is important.

Contact a health care provider if:

• There is redness, swelling, or pain at an incision site.
• There is fluid, blood, or pus coming from an incision.
• Your child feels nauseous or he vomits several hours after coming home.
• Your child has diarrhea or constipation that is not getting better.
• Your child’s pain gets worse.

Get help right away if:

• Your child who is younger than 3 months has a temperature of 100°F (38°C) or higher.
• Your child has a fever or has problems for more than 72 hours.
• Your child has a fever and problems suddenly get worse.
• Your child’s pain does not go away.
• Your child’s pain becomes severe.