Orchiopexy is a surgical procedure that corrects the position of undescended testicles inside the scrotum. Orchiopexy is performed to male children to correct cryptorchidism, a medical term used for any undescended testicles. Orchiopexy can also be performed to male adults or adolescents, which may involve one or both testicles. In adults, orchiopexy is used to treat testicular torsion. Testicular torsion is a condition caused when the testicles rotate and twist the spermatic cord, leading to a loss of blood supply.
Other names that can be used in place of orchiopexy include repair of an undescended testicle, inguinal orchiopexy, testicular torsion repair, and cryptorchidism repair.
Reasons Why Men Should Have an Orchiopexy
Orchiopexy is performed in male individuals for the following reasons:
- To reduce the risks of any traumatic injuries in the testes. If male children have undescended testicles that remain in the groin area, they are likely to injure themselves during physical activities.
- To minimize the risks of becoming infertile. For example, in adult males, cryptorchidism may result in a low sperm count and poor sperm quality.
- Prevent testicular cancer. It has been found that men with undescended testicles have 48 times the chance of developing testicular cancer compared to those who have normal testicular locations.
- To prevent inguinal hernia development.
- To reduce the risk of developing testicular torsion in adolescent males.
- To maintain the normal shape and appearance of the scrotum.
The main and primary reason why adult males and adolescents should have an orchiopexy is to correct testicular torsion rather than cryptorchidism. In case the testicles fail to descend by the time a male child reaches puberty, a complete orchiopexy is required.
How do I prepare for an orchiopexy?
Since orchiopexy is done under general anesthesia, the patient should follow some dietary rules for at least six hours before the surgery. You doctor will give you special instructions that you must follow before the surgery. While male infants may not realize that they are going to have an orchiopexy, older boys may get a bit nervous before the operation. They may feel nervous because their parents may also feel anxious about it. Thus, parents should educate themselves about the procedure to feel comfortable and not pass their anxiety to the boy.
What happens during an orchiopexy?
Orchiopexy is a procedure that can be performed as an outpatient case, which means that the child or adult can have the operation and go home on the same day. Sometimes, a child may be required to stay in a hospital for one night after the surgery in case complications occur during the procedure. You should not give your child any food or drinks on the day of the operation.
The parent will sign a consent form for orchiopexy while the child is being prepared in the treatment room. Preparation for this operation involves an intravenous access on a vein, leg, or arm. Mild pain can be experienced when an IV line is inserted. However, the pain disappears after the insertion.
To start the surgical process, an anesthesiologist intravenously injects a general anesthesia to ensure that the child is fast asleep throughout the surgery.
When the child or adult is asleep, the surgeon makes a small incision into the groin to locate the testicle/s and to free the spermatic artery. The spermatic artery is the artery that holds the testicle in the scrotum. In many cases, a testicle may fail to descend into the scrotum when it is short. Freeing the artery from all the surrounding tissues makes sure that it stretches to its full length. The surgeon will then make another small incision in the scrotum to form a small pouch. The testicle is then gently lowered into the scrotum and then stitched into its right position.
When the procedure is over, the doctor will close the surgical wounds with dissolvable sutures or stitches. The patient will then wake up in the recovery room where the medical team can monitor the vital signs or any post-surgery complications. Once the patient is stable, he can go home.
Recovery from Orchiopexy
After surgery, your child may feel unwell for about 24 hours due to the anesthesia used during the surgery. However, you should not worry about it.
The following tips can speed up the recovery of your child and also reduce any risks and complications that may occur after the surgery:
- You should make sure that your child drinks enough fluids.
- Give pain relievers to your child a few days after the surgery. Some activities such as watching television, playing video games, and reading can help your child keep his mind off the pain.
- Your child should rest for at least a week before returning to school.
- Maintain a proper hygiene as advised by your doctor to quicken wound healing.
- Your child’s groin area is likely to feel sore for a few days after the operation. The child should wear loose clothes to help protect the area.
- Your child should not ride a bicycle or even use toys a few weeks after the operation. Doing so will help the testicles remain in their proper location. You should further ask the surgeon for advice about this matter.
Just like any other type of surgery, an orchiopexy have risks of getting complications. Some of these complications may need further surgery for treatment.
Possible complications and side effects that can result from an orchiopexy include:
- Wound infection
- Bruising, bleeding, and swelling on the surgery site
- Risk of testicles going back to the groin
- Testicular atrophy - a condition where the testicular artery cannot supply enough blood to nourish the testicles. The testicle may wither away as a result.
- The surgery may cause damage to the tube connecting the urethra to the testicle (vas deferens), which can cause problems when passing semen.
In general, there are little complications associated with orchiopexy. The main risk is testicular atrophy that may make your child lose his testicles completely.
The outcome for any orchiopexy procedure is good and the testicles are properly moved into the scrotal sac. However, success rates for this operation may vary depending on the location of the testicles before the surgery. In general, orchiopexy for the correction of undescended testicles works well in almost all males.