What is an Orchidopexy?

D. Jeffress

An orchidopexy is a surgical procedure to correct an undescended testicle, a common problem in male newborns. The operation is usually performed on infants around the age of one whose testicles have not yet fully descended into the scrotum. Some older children, adolescents, and adults may also be candidates for orchidopexy due to congenital problems or following a traumatic injury. Orchidopexy is generally a quick, safe, outpatient procedure with a very high success rate and few risks of complications.

Undescended testicles may increase an individual's risk of developing cancer.
Undescended testicles may increase an individual's risk of developing cancer.

Until recent years, most doctors chose to wait until patients were about one year old before considering orchidopexy. The surgery involved making relatively large cuts so the testicle could be manually retrieved from the inguinal canal in the lower abdomen and fitted into the scrotum. Newer innovations in urology techniques and surgical equipment now make it easier for specialists to perform the operation earlier, typically in the three- to six-month-old range. Early intervention has proven to be a less-invasive procedure that reduces the chances of permanent damage to the testicle or surrounding nerves, blood vessels, and body tissue.

An orchidopexy is a surgical procedure to correct an undescended testicle.
An orchidopexy is a surgical procedure to correct an undescended testicle.

A patient is usually given a small dose of general anesthesia before surgery. Monitoring equipment is set up in the operating room to check vital signs, breathing, and brain wave activity. After detecting the precise location of the undescended testicle with ultrasounds and computerized tomography scans, the surgeon makes a small incision in the lower abdomen. An endoscopic camera is often used to help the surgeon carefully visualize the surgery without needing to make large open cuts.

An endoscope may be used during an orchidopexy.
An endoscope may be used during an orchidopexy.

With the aid of the endoscope, the surgeon locates the spermatic cord and untwists or frees it as necessary from surrounding structures. He or she then carefully manipulates the testicle downward. Another small incision is usually made at the base of the scrotum to help guide the testicle into place from the bottom. In order to prevent the testicle from retracting back into the inguinal canal, several small, dissolvable stitches are used to suture it to the scrotal wall.

General anesthesia is used when performing an orchidopexy.
General anesthesia is used when performing an orchidopexy.

Orchidopexy can usually be completed in less than an hour, after which the patient is brought to a recovery room until the anesthesia wears off. The surgeon may decide to keep the patient in the hospital overnight to monitor recovery and make sure complications do not arise. Most infants are able to go home with their parents the following day with instructions on dressing the surgical scars and limiting physical activity for four to six weeks. Follow-up visits with a pediatrician are common to ensure the procedure was successful. The majority of babies who undergo surgery are able to mature at a normal rate and not experience reproductive problems in the future.

A computerized tomography scan may help locate an undescended testicle.
A computerized tomography scan may help locate an undescended testicle.
A patient may be required to stay overnight in a hospital following an orchidopexy.
A patient may be required to stay overnight in a hospital following an orchidopexy.
Undescended testicles are more likely to occur when baby boys are premature.
Undescended testicles are more likely to occur when baby boys are premature.

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