Testicles should move down from the abdomen into the scrotum before birth.
Some boys are born with 1 or both testicles still inside the abdomen or groin. This is called
undescended testicles. Orchiopexy is a surgery to lower the testicle(s) into the scrotum.
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Reasons for Procedure
Orchiopexy is done to treat undescended testicles. The surgery may improve fertility. Persons with undescended testicles also have a higher risk of developing cancer later in life. Having the testicle in the scrotum makes it easier to check for early signs of cancer.
Problems from the procedure are rare, but all procedures have some risk. Your child's doctor will review potential problems, like:
- Movement of the testicle back up into groin after surgery
- Damage to or loss of the testicle
- Reaction to anesthesia
- Injury to surrounding structures
What to Expect
Prior to Procedure
Your child’s doctor will do the following before the surgery:
- Physical exam
- Imaging, blood, and urine tests
- Discuss the anesthesia being used and the risks of surgery
Talk to the doctor about your child’s medications or any recent illnesses. You may be asked to have your child stop or start certain medications before surgery.
Other things to keep in mind before the procedure include:
- Bring special toys, books, and comfortable clothing for your child.
Your child will need to avoid eating for a period of time before surgery.
- For children younger than 1 year, it is often recommended that they do not eat after midnight the night before the surgery.
- Clear liquids, such as breast milk, water, and clear juices, may be allowed up to 2 hours before the procedure.
will be used. It will keep your child asleep during the surgery and block pain.
Description of the Procedure
Small keyhole incisions will be made in 1 or both sides of the groin and in the abdomen. Long, thin tools will be passed through the incisions. They will allow the doctor to view and operate inside the body. First, the testicle will be examined.
Next, a pouch will be created in the scrotum. The testicle will be pulled down into the newly created pouch. Permanent stitches will hold the testicle in place. All other incisions will also be closed with stitches that will dissolve on their own.
In some cases, a small button will be placed on the outside of the scrotum. The button will hold the testicle down until healing occurs. The doctor removes the button by cutting the stitches a few weeks after the procedure.
A medication may be given during the surgery to help manage discomfort after the procedure. In most cases, your child can go home from the hospital on the same day as the surgery.
How Long Will It Take?
1 hour per testicle
How Much Will It Hurt?
Anesthesia prevents pain during surgery. Your child will be given medication to relieve pain or soreness during recovery.
At the Care Center
- Your child will be monitored while recovering from the anesthesia.
- Your child will be given pain medications as needed.
During your child's stay, the care center staff will also take steps to reduce the chance of infection, such as:
- Washing their hands
- Wearing gloves or masks
- Keeping your child's incisions covered
There are also steps you can take to reduce your child's chance of infection, such as:
- Washing both you and your child's hands often, and reminding visitors and healthcare providers to do the same
- Reminding your child's healthcare providers to wear gloves or masks
- Not allowing others to touch your child's incision
When your child returns home, do the following to help ensure a smooth recovery:
- Give medications to treat pain and prevent infection as directed.
- Engage in gentle play. Avoid tiring activities for a few weeks. Your child should avoid sitting on or riding a bicycle or other toys that require straddling for about a week after the surgery.
- Monitor your child for signs of pain. These may include irritability, trouble moving, sweating, or pale skin.
Call Your Child’s Doctor
It is important to monitor your child's recovery. Alert your child's doctor to any problems. If any of the following occur, call your child's doctor:
- Increasing pressure or pain
- Redness, drainage, puffiness, or soreness around the incision site(s)
- Changes in frequency, odor, appearance, or volume of urine
- Difficulty urinating
- Signs of infection, including fever or chills
- Persistent nausea and/or vomiting
- Abdominal pain
- Lack of energy
- Loss of appetite
If you think your child has an emergency, call for emergency medical services right away.
Family Doctor—American Academy of Family Physicians
Healthy Children—American Academy of Pediatrics
Caring for Kids—Canadian Pediatric Society
Elyas R, Guerra LA, Pike J, et al. Is staging beneficial for Fowler-Stephens orchiopexy? A systematic review.
J Urol. 2010;183(5):2012-2018.
Cryptorchidism. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated May 23, 2016. Accessed June 1, 2016.
Orchiopexy discharge instructions. Children’s Hospital and Clinics of Minnesota website. Available at:
http://www.childrensmn.org/Manuals/PFS/Surg/018757.pdf. Updated October 2013. Accessed June 1, 2016.