Has your son's testicles descended? Let's learn about orchiopexy surgery!

Have you noticed that one or both of your little boy's testicles (balls) are not in his scrotum? Or is your young son suddenly complaining of unbearable pain in the scrotum area? Today we are talking about a surgery that is necessary in both cases and often gives successful results. Don't be afraid of this, let's understand everything clearly.

Simply put, what is Orchiopexy?

Orchiopexy is a surgical procedure. It does two main things. One is to move a baby's undescended testicles, either inside the abdomen or in the groin, back into their proper place, the scrotum. The other is to fix a twisted testicle, which has cut off blood flow, and to fix the testicle back into the scrotum. Sometimes, during this procedure, doctors may need to repair a hernia or insert a testicular prosthesis. This procedure is also called an orchidopexy.

What conditions does this surgery treat?

As we discussed earlier, this surgery treats two main conditions. There is a clear difference between the two.

What is the best age to have orchiopexy surgery?

This depends on which of the two situations we talked about.

• For Undescended Testicles: If the testicles have not descended on their own by the time the child is about 6 months old, doctors usually recommend performing this surgery between 6 and 24 months (2 years) .

• For Testicular Torsion: This is an emergency that requires immediate treatment. Age is not relevant here. If blood flow is not restored within 6 hours of the onset of symptoms, the testicle can die. In that case, it will have to be removed surgically. Therefore, in such a situation, it is essential to go to a hospital's Emergency Treatment Unit (ETU) immediately.

How to prepare for surgery?

If your child is having this surgery, your doctor will give you a set of clear instructions. It is very important to follow these instructions exactly to minimize complications.

Here are some things to do before surgery for undescended testicles:

• Do not give any solid food for eight hours before surgery.
• Do not give powdered milk or cow's milk for six hours before surgery.
• Stop breastfeeding four hours before surgery.
• Stop giving fluids such as water and fruit juice two hours before the surgery.
• The day before surgery and the morning of surgery, thoroughly wash and clean the child's abdomen and groin area.

If your child takes any medications daily, you can give them on the day of surgery, unless the doctor advises otherwise. But don't forget to inform the doctor about all medications and vitamins your child takes .

What happens during the surgery?

This surgery is performed by a team of pediatric specialists, including a pediatric surgeon, an anesthesiologist, and pediatric nursing staff.

For Undescended Testicles

1. First, the child is anesthetized (general anesthesia). This means the child doesn't feel any pain and is fast asleep.

2. A very small incision is made in the groin area or scrotum.

3. The undescended testicle and the duct connected to it are found.

4. The testicle is examined. If it is not healthy, it may need to be removed and a prosthesis inserted.

5. A small sac-like space called a ``Dartos pouch'' is created inside the scrotum to hold the testicle.

6. Carefully pull the testicle down and secure it inside the pouch.

7. Dissolvable stitches are used for this.

8. Finally, the incisions are closed and bandaged.

For Testicular Torsion

1. A small incision is made in the scrotum.

2. The twisted spermatic cord is straightened and the testicle is examined.

3. If the testicle is healthy, it is fixed to the scrotum and sewn to prevent it from twisting again.

4. If the testicle is not healthy (has died), it can be removed and an artificial one can be inserted if necessary.

5. The wound is closed with dissolvable stitches.

This surgery usually takes about 60 minutes .

What are the benefits and possible risks of surgery?

Like any surgery, this one has benefits and minor risks.

How to take care of the baby during the recovery period?

After the surgery, the child will be moved to a recovery room and observed for a few hours. Since this is an outpatient procedure, you can often go home the same day.

• Pain: There may be some pain for a few days or a week. Give painkillers as prescribed by your doctor. Do not give any medicine without consulting your doctor.
• Fatigue: The anesthesia may cause the child to feel more tired and sleepy than alert for a few days.
• Food: Give fluids and light foods like applesauce, bananas, and rice for the first 24 hours.
• Cleanliness: Keep the wound clean to prevent infection. Wash your hands thoroughly with soap and water before touching your child's wound.
• Bathing: Consult your doctor about bathing. They may recommend limiting yourself to a sponge bath for a few days.
• Most importantly: Avoid activities like running, jumping, and riding toys (bikes, rocking horses) for at least two weeks. Always check with your doctor before returning to sports.

Most children can return to school or daycare in about three to five days.

When should I see the doctor again?

You will have to go for a follow-up two weeks after the surgery. Then you will be asked to go for another one, maybe in two or three months.

It's normal for parents to be nervous about having surgery on their child. But remember that orchiopexy is a very common, safe, and highly effective procedure. Talk openly with your doctor about any questions or concerns you may have.

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