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Undescended testicle repair
Definition
Undescended testicle repair is surgery to correct testicles that have not dropped down into the correct position in the scrotum.
Alternative Names
Orchidopexy; Inguinal orchidopexy; Orchiopexy; Repair of undescended testicle; Cryptorchidism repair
Description
As a baby grows in the womb, the testicles develop in the infant's abdomen. They drop down into the scrotum during the last months before birth.
In some newborns, however, one or both testicles do not move down into the correct position. About half of these cases will descend within the first year of life without medical treatment.
Undescended testicle repair surgery is recommended for patients whose testicles do not descend on their own.
The surgery is done while the child is asleep (unconscious) and pain-free under general anesthesia. The surgeon makes a cut in the groin, where most undescended testes are located.
After finding the cord that holds the testis in the scrotum, the surgeon unties it from the tissue around it so that the cord's full length is used. A small cut is made in the scrotum, and a pouch is created. The testicle is carefully pulled down into the scrotum, and stitched into place. Stitches are used to close any surgical cuts.
In some cases, the procedure can be done laparoscopically, which involves smaller surgical cuts.
Why the Procedure Is Performed
This surgery is recommended for infants older than 1 year whose testicles have not descended into the scrotum (cryptorchidism).
An undescended testicle is different from a "retractile" testicle, in which the testicle drops into the scrotum and then pulls back. Retractile testicles do not need surgery.
Risks
Risks for any anesthesia are:
- Reactions to medications
- Problems breathing
Risks for any surgery are:
- Bleeding
- Infection
After the Procedure
Undescended testicle repair is successful in most cases. A small percentage of men will have fertility problems. (See: Infertility)
Men who have had undescended testicles should do monthly self-exams throughout their lives for possible tumors. People with undescended testes have higher rates of testicular cancer than those with normal testicle development, even if they have a fully descended testicle on the other side.
Outlook (Prognosis)
The surgery may be done on an outpatient basis. Bed rest is recommended for the first 2 - 3 days. Avoid strenuous activity, including bicycling, for at least 1 month to allow the testicle to heal in its new position.
References
Barthold JS. Abnormalities of the testes and scrotum and their surgical management.In: Wein AJ, ed. Campbell-Walsh Urology. 10th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 132.
Elder JS. Disorders and anomalies of the scrotal contents.In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 19th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 539.
Reviewed By: Linda J. Vorvick, MD, Medical Director and Director of Didactic Curriculum, MEDEX Northwest Division of Physician Assistant Studies, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington. Louis S. Liou, MD, PhD, Chief of Urology, Cambridge Health Alliance, Visiting Assistant Professor of Surgery, Harvard Medical School. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.
