What is an Orchidopexy?
Orchidopexy is the name of the operation to move a testicle to the right place in the scrotum. In the majority of cases the operation involves moving an Undescended Testicle from the groin to the scrotum. If the testicle is impalpable then a slightly different operation is used, and there is a separate information leaflet available for this condition.
How is the operation done?
The operation is usually done as a day case procedure - meaning that you come in and go home on the same day.
Occasionally there may be a surgical or anaesthetic reason to recommend an overnight stay. This will be discussed with you at the time of surgery.
The operation is done with the patient asleep under a Full General Anaesthetic.
As well as the general anaesthetic the patient will have local anaesthetic for pain relief which will work after the surgery has finished. The local anaesthetic may be injected around the wound (local block) or may be injected into the patients back. This is called a Caudal Block, and is a very effective method of pain relief after the surgery.
The surgery involves making a little cut in the groin and going down to find the testicle. The testicle is then freed from everything that is keeping the testicle in the groin. Once the testicle has enough length to bring it to the scrotum, a second cut is made on the scrotum and a pouch is created in the scrotum. The testicle is passed down to the scrotum and placed into the scrotum.
The wounds are then closed with dissolving stitches. Sometimes paper stitches or a dressing is put over the wound.
If there testicle is undescended on both sides then the operation is carried out on each side - meaning that there will be cuts on each side.
Can the surgery be done keyhole?
It is not possible to do this operation keyhole. Keyhole surgery is used if the testicle is impalpable - this is a very different condition.
How long will the surgery take?
The operation usually takes around 45 minutes of operating time if it is uncomplicated. This does not include the time for giving the anaesthetic before the operation or the recovery afterwards.
Are there any risks to the surgery?
All operations carry a risk of complications. The potential complications of an orchidopexy include:
- BLEEDING - If it does happen it normally settles by itself and you see it as bruising. This normally settles by itself, but very occasionally needs a further operation. Occasionally if there is a lot of bleeding in the scrotum then a collection of blood, called a Haematoma, can form.
- INFECTION - If this occurs it may need to be treated with antibiotics
- INJURY TO THE BLOOD VESSELS OR THE SPERM TUBE (VAS) - Every care is taken to prevent this from happening. The risk of this happening is very small.
- TESTICULAR ATROPHY - If the sperm tube or blood vessels are damaged during the operation this can result in not enough blood getting to the testicle. This can cause the testicle to die because it is starved of oxygen. This is seen by the testicle shrinking and disappearing. There is nothing that can be done to save the testicle if this happens. The risk of this happening is approximately 1%.
- TESTICULAR ASCENT - Scar tissue heals by shortening. After the operation the scar tissue can pull the testicle into the groin. This may not become apparent for many years. If this happens your son would require another operation to bring the testicle down to the scrotum again. The risk of this is very small (less than 1%)
What Happens after the operation?
After the operation your son will wake up and be able to have something to eat and drink straight away. Most children who have this operation go home the same day. This may not be possible if your son is very young, has other medical problems or something unexpected happened during the operation.
It is not uncommon for children to feel a bit sick for the first 24 hours after an anaesthetic. You should encourage your son to drink lots of fluid. As long as he is drinking it does not matter if he is off his food for a day or two.
After the operation you should keep the wounds dry for 5 days. Do not allow your son to have a bath for 5 days, but you can use wet wipes to keep the area clean. You should get your GP to check the wound after a week.
Give your son regular pain relief for the first couple of days after the operation. Giving pain killers regularly is much more effective that waiting for someone to complain of pain before giving them something.
Typical appearance of wounds after an orchidopexy. There is a wound in the groin and in the scrotum.
You should call the ward or your family doctor (GP) if:
- your child is in a lot of pain and pain relief does not seem to help
- your child has a high temperature and paracetamol does not bring it down
- the wound site looks red, inflamed and feels hotter than the surrounding skin