Orchidopexy for a Palpable Testicle in Children

Orchidopexy is a surgical procedure used to treat undescended testicles, also known as cryptorchidism. The goal of the surgery is to move the undescended testicle into its proper position in the scrotum.

What is an Undescended Testicle?

An undescended testicle is a condition where one or both testicles have not moved down into the scrotum during fetal development. This can occur in about 3% of full-term male infants and up to 30% of premature male infants.

Types of Undescended Testicles

There are two types of undescended testicles:

• Palpable undescended testicle: The testicle can be felt in the groin or abdomen, but it has not moved down into the scrotum.
• Non-palpable undescended testicle: The testicle cannot be felt in the groin or abdomen, and its location is unknown.

Benefits of Orchidopexy for a Palpable Testicle

The benefits of orchidopexy for a palpable testicle include:

• Reduced risk of testicular cancer: Undescended testicles have a higher risk of developing testicular cancer. Moving the testicle into the scrotum can reduce this risk.
• Improved fertility: Orchidopexy can improve fertility by allowing the testicle to develop and function normally.
• Reduced risk of testicular torsion: Undescended testicles are at higher risk for testicular torsion, a condition where the testicle twists and cuts off its blood supply. Orchidopexy can reduce this risk.
• Cosmetic benefits: Orchidopexy can improve the appearance of the scrotum and provide a more normal appearance.

Surgical Procedure

The surgical procedure for orchidopexy typically involves:

• General anesthesia: The child is given general anesthesia to ensure they are comfortable and pain-free during the procedure.
• Incision: A small incision is made in the groin or abdomen to locate the undescended testicle.
• Mobilization of the testicle: The surgeon gently mobilizes the testicle and brings it down into the scrotum.
• Fixation of the testicle: The testicle is fixed in place using sutures or other techniques to prevent it from moving back up into the abdomen.
• Closure of the incision: The incision is closed, and the child is taken to the recovery room.

Postoperative Care

After the surgery, the child will need:

• Pain management: Pain medication will be given to manage any discomfort or pain.
• Rest: The child should rest and avoid strenuous activities for a few days after the surgery.
• Follow-up care: Follow-up appointments with the surgeon will be necessary to monitor the child's progress and remove any sutures or staples.

Risks and Complications

As with any surgical procedure, there are risks and complications associated with orchidopexy, including:

• Bleeding or hematoma: Bleeding or hematoma can occur at the surgical site.
• Infection: Infection can occur at the surgical site or in the testicle itself.
• Testicular atrophy: The testicle may shrink or become non-functional after the surgery.
• Recurrence: The testicle may move back up into the abdomen, requiring additional surgery.

Long-term Outcomes

The long-term outcomes for children who undergo orchidopexy for a palpable testicle are generally good. Most children will have:

• Normal testicular development: The testicle will develop and function normally.
• Improved fertility: Fertility will be improved, and the child will have a normal chance of fathering children when they grow up.
• Reduced risk of testicular cancer: The risk of testicular cancer will be reduced.