Is your son's testicle missing from the scrotum? Here is what you need to know about orchiopexy surgery!

Have you ever noticed that one of your little boy's testicles is missing from the scrotum? Or perhaps your teenage son is suddenly complaining about severe pain in his groin area? Both of these situations can be worrying for any parent.

Today we are going to talk about a very important surgical procedure that helps with both of these conditions. Do not be afraid when you hear about surgery because this is a common and very successful operation.

Let us walk through everything you need to know about orchiopexy, from why it is needed to how you can care for your child safely at home.

What is Orchiopexy in Simple Terms?

Orchiopexy is a surgical procedure that serves two main purposes. First, it brings a testicle that is stuck inside the abdomen down into the scrotum and secures it in place if it failed to descend naturally.

Second, it fixes sudden twists in the testicle known as testicular torsion. The surgeon untwists the blood supply and fastures the testicle securely inside the scrotum to prevent future twisting.

Sometimes, doctors may also repair a hernia during the same surgery or place a synthetic artificial testicle if necessary. This procedure is also known as orchidopexy.

When is This Surgery Needed?

As we discussed earlier, doctors use orchiopexy to treat two distinct medical conditions. Let us look at both situations in more detail.

What is the Best Age for the Surgery?

The timing of the surgery depends entirely on the specific medical condition your child is facing.

• For Undescended Testicles: Doctors usually wait for about six months to see if the testicle moves down on its own. If it does not descend, doctors recommend performing the surgery between six months and 24 months of age. Early surgery helps lower the risk of future fertility problems and testicular cancer.
• For Testicular Torsion: Age does not matter for torsion because it is an emergency. You must rush to the nearest emergency department right away when pain begins. If surgery does not restore blood flow within six hours, the testicle can suffer permanent damage and might need removal. Never delay if you suspect torsion.

How Do You Prepare for Surgery?

When your doctor schedules an orchiopexy for your child, they will give you clear instructions. Following these rules carefully helps minimize risks during anesthesia.

• Stop giving solid foods eight hours before the scheduled surgery time.
• Stop formula milk or cow milk six hours before the procedure.
• Stop breast milk feeding four hours before the surgery.
• Stop clear liquids like water and fruit juice two hours before the surgery.
• Wash your child's abdomen and groin area thoroughly the night before and on the morning of surgery.

If you are rushing to the hospital for an emergency testicular torsion surgery, you will not have time for this preparation. Still, remember to inform the medical team about any medicines your child takes.

What Happens During the Surgery?

A specialized pediatric medical team performs this procedure. This team includes a pediatric surgeon or pediatric urologist, a pediatric anesthesiologist, and pediatric nursing staff.

Surgery for an Undescended Testicle

1. First, the medical team gives the child general anesthesia so they sleep comfortably throughout the procedure without feeling any pain.
2. The surgeon makes a small incision in the groin or scrotum.
3. The surgeon locates the undescended testicle and its attached spermatic cord through this opening.
4. The surgeon checks the health of the testicle. If it is unhealthy, they may remove it and insert a synthetic prosthesis.
5. The surgeon creates a small pocket inside the scrotum called a dartos pouch.
6. They gently guide the testicle into this pocket and secure it using dissolving stitches.
7. Finally, the surgeon closes the skin incision using medical glue or surgical tape.

Surgery for Testicular Torsion

1. The surgeon makes a small incision in the scrotum.
2. They untwist the spermatic cord and check the testicle.
3. If the testicle is healthy and blood flow returns, they secure it inside the scrotum so it cannot twist again.
4. If the testicle is unhealthy due to lack of blood flow, they may remove it and offer an artificial implant option.
5. They close the incision with dissolving stitches and place a protective bandage.

The entire surgical procedure usually takes about one hour.

What Happens After the Surgery?

After surgery, nurses move your child to a recovery room. The medical team monitors your child's vital signs there for about two hours.

This is typically an outpatient procedure, meaning your child can go home on the same day. If everything looks stable, you can take your child home to recover.

What Are the Benefits of This Surgery?

• Health Benefits: Surgery prevents future fertility problems caused by untreated undescended testicles. Having the testicle in the proper place also makes it easier for your son to perform self-examinations for testicular cancer when he grows up.
• Reduced Injury Risk: When a testicle stays in the groin, it faces a higher risk of injury from seatbelts, tight clothing, or sports. Surgery eliminates this danger.
• High Safety Profile: Orchiopexy is a very safe surgical procedure with a low rate of complications.

Are There Any Risks?

Like any surgery, orchiopexy carries minor risks, though serious complications are rare.

• Adverse reactions to anesthesia .
• Wound infection .
• Blood clots or hematoma near the incision site .
• Swelling and bruising .
• Scarring .

In very rare cases, the testicle can move back upward after surgery, which is called a reascending testicle. If this happens, another minor procedure may be necessary.

How to Care for Your Child at Home After Surgery?

Your child may feel sore or uncomfortable for a few days after surgery. The dissolving stitches will disappear on their own within two weeks.

Anesthesia can make your child feel tired, so they might sleep more than usual. Vomiting on the first day can also happen sometimes.

Tips for looking after your child at home:

• Pain Control: If your child has pain, give pain relievers like acetaminophen or ibuprofen strictly according to your doctor's dosage recommendations.
• Cold Compresses: Wrap an ice pack in a clean cloth and apply it near the incision area for 10 to 20 minutes, four times a day, to reduce swelling and bruising.
• Diet: Offer light, soft foods during the first 24 hours, such as water, broth, soup, yogurt, and rice porridge.
• Restricted Activities: This is very important. Keep your child from running, jumping, riding bicycles, or playing rough games for at least two weeks. Such activities can tear the stitches.
• Keep the Wound Clean: Keep the incision area clean to prevent infections. Always wash your hands with soap before touching your child's wound. Follow your doctor's guidelines on when your child can take a bath.

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

When Should You Contact the Doctor?

Your doctor will likely schedule a follow-up visit about two weeks after surgery. In addition, contact your doctor right away if you notice any red flag symptoms.

It is completely normal to feel nervous when your child needs surgery. However, knowing that orchiopexy is a safe, short procedure with great success rates should bring you peace of mind.

If you have any further questions or worries, talk openly with your pediatrician or pediatric surgeon.