Have you noticed that one of your little boy's testicles is not in the scrotum? Or is your young son suddenly complaining of severe pain in the testicles? Today we are going to talk about a very important surgery that comes to the rescue in both such cases. Don't be afraid to hear this. This is a very common and successful surgery.
Simply put, what is Orchiopexy?
Orchiopexy (pronounced 'o-kee-yo-pek-see') is a surgical procedure. It does two main things. One is to surgically move the testicles, which are born in the abdomen, into the scrotum, if they are not in the right place. The other is to correct a testicular torsion, which is a twisting of the blood vessel that supplies the testicle, and to reattach the testicle from within the scrotum.
Sometimes, at the same time as this surgery, doctors will repair a hernia if there is one, or if necessary, they may insert a testicular prosthesis. This surgery is also called `Orchidopexy`.
In what cases is this surgery necessary?
As we discussed earlier, Orchiopexy surgery is mainly used to treat two conditions. Let's understand these two conditions a little more clearly.
| Condition | A simple explanation |
|---|---|
| Undescended Testicles | Normally, when a male baby is in the womb, the testicles develop inside the abdomen. As the baby gets closer to birth, they gradually descend into the scrotum. However, in some babies, one or both testicles do not descend at birth or within the first few months after birth. This is what we call this condition. |
| Testicular Torsion | This is a medical emergency . What happens here is that the spermatic cord, which is the blood vessel that carries blood to the testicle and other tissues, suddenly twists. When this twists, the blood supply to the testicle stops completely, and it begins to malfunction. This causes severe pain. |
What is the best age to have surgery?
This is determined by the condition of the patient.
- For undescended testicles: If one of your son's testicles has not descended, doctors usually wait about 6 months to see if it will descend on its own. If it has not, it is recommended to perform this surgery between 6 and 24 months (2 years) . Having surgery during this time can reduce the risk of future infertility and testicular cancer.
- For Testicular Torsion: There is no age limit for this. This is an emergency . You should go to a hospital's Emergency Department (ETU) as soon as possible after the pain starts. If surgery is not performed within 6 hours and blood flow is not restored, the testicle may be damaged and may have to be removed. So, if you experience this kind of pain, do not delay even a moment.
How do you prepare before surgery?
When your child is scheduled for an orchiopexy, your doctor will give you all the instructions you need. It is very important to follow these instructions exactly to minimize complications.
- Do not give any solid food 8 hours before surgery .
- Stop giving powdered milk or cow's milk 6 hours before surgery .
- Stop breastfeeding 4 hours before surgery .
- Stop giving clear liquids like water and fruit juice 2 hours before surgery .
- The day before surgery and the morning of surgery, wash and keep the child's abdomen and groin area clean.
Unless otherwise instructed by the doctor, your child's usual medications can be given on the day of surgery. However, be sure to tell the doctor about any medications your child is taking, including vitamins, Ayurvedic, or herbal supplements. Some medications can increase the risk of bleeding.
If you are having emergency surgery due to testicular torsion, you won't have time to prepare like this. Don't forget to tell your doctor about any medications you are taking at that time.
What happens during the surgery?
This surgery is performed by a team of pediatric specialists, including a pediatric surgeon or pediatric urologist, a pediatric anesthesiologist, and a pediatric nursing staff.
Surgery for an undescended testicle
1. First, the child is given general anesthesia . This means that the child is sound asleep throughout the surgery. He or she will not feel or remember anything.
2. The doctor will then make a small incision in the baby's groin or scrotum.
3. Through it, the undescended testicle and the blood vessel (spermatic cord) connected to it are found.
4. The testicle is examined. If its health is not good, it may have to be removed and replaced with an artificial one (prosthesis).
5. A small space (Dartos pouch) is created inside the scrotum to hold the testicle.
6. Then, the testicle is slowly brought into that space and secured with dissolving stitches .
7. Finally, the incisions are closed and a type of glue or bandages are applied.
Surgery for Testicular Torsion
1. The surgeon makes an incision in the scrotum.
2. The twisted spermatic cord is straightened and the testicle is examined.
3. If the testicle is healthy (blood flow has returned), it is fixed inside the sac to prevent it from twisting again.
4. If the testicle is not healthy (if blood flow has been stopped for a long time), it will have to be removed. If necessary, an artificial one can be inserted in its place.
5. The incision is closed with dissolvable stitches and a plaster is applied.
This surgery usually takes about an hour .
What happens after the surgery?
After the surgery, the child will be transferred to a recovery room. There, the medical staff will monitor the child's condition for about two hours. This is usually an outpatient procedure, meaning you can go home the same day without having to stay in the hospital. So if everything goes well, you can go home the same day.
What are the benefits of this surgery?
- Health benefits: This surgery can prevent future infertility in the child. Also, having the testicles in the correct position makes it easier to self-examine for testicular cancer when the child is an adult.
- Reduced risk of injury: When a testicle is in a place like the groin, there is a greater chance of injury from being caught in a seat belt or tight clothing while playing sports. This risk disappears after surgery.
- Safety: Orchiopexy is a relatively safe surgery with few complications.
Are there any risks in this?
As with any surgery, there are some risks involved, but these are very rare.
- Adverse reactions to anesthesia
- Infection
- Hematoma (blood clot) at the wound
- Swelling and Bruising
- Scarring
Very rarely, the testicle can move back up (reascending testicle) after surgery. If this happens, another surgery will be required.
How to take care of yourself at home after surgery?
The child may feel some pain or discomfort for a few days after the surgery. The stitches will dissolve in about two weeks. The child may feel a little tired for a few days due to the anesthesia and may be more sleepy than alert. There may also be vomiting on the first day.
Remember, every child recovers at a different rate, so follow your doctor's instructions exactly.
When caring for your child, keep these things in mind:
- Pain control: If your child is in pain , ask your doctor and give him or her a pain reliever such as Acetaminophen (Panadol) or Ibuprofen (Bruffen) only in the amount he or she recommends .
- Ice: Applying an ice pack wrapped in a clean cloth to the wound for 10-20 minutes four times a day can help reduce swelling, bruising, and pain.
- Food: Give light, liquid foods such as water, soup, porridge, yogurt, and rice within the first 24 hours.
- Activity Restriction: This is very important . For at least two weeks after surgery, your child should be completely prevented from running, jumping, riding a bike, or sitting on toys like rocking horses. Doing these things can damage the stitches.
- Keeping the wound clean: To prevent infection, keep the wound and the surrounding area as clean as possible. Always wash your hands with soap and water before touching your child's wound. Ask your doctor about bathing your child.
Most children are able to return to school or daycare in about three to five days.
When do you want to see the doctor again?
Your doctor will ask you to come back about two weeks after your surgery. In addition, if you have any of the following symptoms, you should call your doctor immediately.
| If you have these symptoms, call your doctor immediately! | |
|---|---|
| 🔴 | If the wound is bleeding heavily, oozing pus, or has a bad odor. |
| 🔴 | If the child has a fever. |
| 🔴 | If the pain becomes too severe to be controlled with the medication prescribed by the doctor. |
| 🔴 | If the swelling is getting worse. |
It's normal for anyone to be scared when hearing about surgery for their child. But you can rest assured that orchiopexy is a safe, short procedure with very successful results. If you have any questions or concerns, be sure to discuss them openly with your doctor.
Take-Home Message
- Orchiopexy is a safe, common surgery that treats two conditions: undescended testicles and testicular torsion.
- Testicular torsion is an emergency. In such cases, you should go to a hospital's emergency room (ETU) immediately. Every moment of delay can damage the testicle.
- Follow your doctor's instructions carefully after surgery, especially regarding activity restrictions (no running or jumping for 2 weeks).
- If you notice warning signs such as fever, severe pain, or pus coming from the wound, inform your doctor without delay.
💬 Comments (0)
No comments yet. Be the first to share your thoughts here.
Add Your Comment