Introduction
Orchidopexy is a surgical procedure used to fix undescended testicles, a condition known as cryptorchidism. In many boys, both testicles move down from the belly into the scrotum before birth. But sometimes one or both testicles don’t descend properly. This can lead to problems like pain, fertility issues, and a higher risk of testicular cancer later in life if not treated.
Orchidopexy helps bring the undescended testicle down into the scrotum and secure it in place. It’s usually done in infants or young boys but can be performed in older boys or even adults if the condition wasn’t corrected earlier. Modern techniques make this surgery precise and relatively low risk. The goal is to place the testicle where it’s easier to monitor, protect it from heat inside the belly, and help it function as normally as possible.
Who May Need Orchidopexy?
Orchidopexy may be recommended for:
- Boys with undescended testicles at birth
- Children whose testes haven’t descended by 6–12 months of age
- Boys whose testicles moved back up after initially descending
- Males with inguinal hernias and undescended testicles
- Older boys or adults whose condition wasn’t treated earlier
Usually, doctors prefer to fix this early because waiting too long can affect fertility and increase risks. Your paediatrician or urologist will examine your child and decide the right time.
Why Is Orchidopexy Important?
Leaving a testicle in the belly can cause issues:
- Higher risk of testicular cancer later in life
- Infertility risk if both testicles are affected
- Hernia development alongside the undescended testicle
- Testicular torsion, where the testicle twists and causes pain
- Psychological or cosmetic concerns as the child grows
Orchidopexy reduces these risks by placing the testicle in the scrotum, where it’s cooler and easier to check with self-exams or doctor visits.
Types of Orchidopexy
There are two main approaches:
1. Standard Orchidopexy (Open Surgery)
A small incision is made in the groin area. The surgeon finds the undescended testicle, brings it down carefully, and fixes it gently inside the scrotum.
2. Laparoscopic Orchidopexy
This uses a tiny camera and small instruments inserted through tiny cuts in the belly. The surgeon watches on a screen and brings the testicle down under direct vision. This option is often used when the testicle is high inside the abdomen.
The choice depends on where the testicle is located and your child’s anatomy.
Orchidopexy Procedure
Orchidopexy is usually done in a hospital under general anesthesia so the child sleeps through the operation and doesn’t feel anything.
Steps in the Procedure
1. Preparation: Your child’s health is checked, blood tests are done, and anaesthesia is explained.
2. Anaesthesia: General anaesthesia ensures no pain or awareness during surgery.
3. Incision: The surgeon makes a small cut in the groin or belly.
4. Locating the Testicle: The undescended testicle is gently found and evaluated.
5. Mobilisation: The surgeon releases tissues holding the testicle too high and brings it down toward the scrotum.
6. Fixation: The testicle is carefully fixed inside the scrotum using stitches that hold it in place.
7. Closure: The tiny incisions are stitched up or closed with absorbable sutures.
The procedure usually takes about 1–2 hours depending on the position and how many testicles need fixing.
Recovery & Aftercare
Because orchidopexy is minimally invasive, recovery is relatively smooth. Most children go home within a few hours to one day after surgery.
After Surgery
- Your child may feel some mild soreness or discomfort; pain medicines help.
- The scrotum may be slightly swollen or bruised for a few days.
- You’ll be shown how to care for the wound and what to watch for.
- A support garment or loose underwear helps protect the testicle as it heals.
At Home
- Avoid rough activities for about 1–2 weeks.
- Limited bathing until the wounds are dry and healed. Your surgeon will guide you.
- Watch for signs of infection, such as redness, increasing pain, fever, or discharge, which need prompt attention.
Most children return to school and regular activities within a week or so, but heavy sports and rough play should wait until healing is confirmed.
Risks & Possible Complications
Orchidopexy is generally safe and successful, but like all surgeries, it has some risks:
- Infection at the incision site
- Bleeding or hematoma (blood buildup under skin)
- Testicle not staying in scrotum (re-ascend)
- Small scar formation
- Anesthesia risks (very rare in healthy children)
- Testicular atrophy (rare outcome where the testicle shrinks)
Your surgeon will explain these risks before surgery and guide you about warning signs that need medical attention.
Pediatric Surgery
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