Treatment / Other Scrotal Operations

Orchidopexy: Overview

Introduction

Orchidopexy, commonly known as testicular descent surgery, is a surgical procedure performed to move an undescended testicle into the scrotum. This guide will help you understand the indications, types, and post-operative care for the procedure.

Indications for Orchidopexy

Orchidopexy is primarily indicated for:

1. Cryptorchidism (Undescended Testicles): When one or both testicles haven’t descended into the scrotum by the time a baby is several months old.
2. Testicular Torsion: To prevent rotation of the testicles, which can cut off blood supply and lead to tissue death.
3. Inguinal Hernia: Sometimes, alongside repairing an inguinal hernia, orchidopexy may be necessary.

Types of Orchidopexy

1. Standard Orchidopexy: This is performed for an undescended testicle that’s located near the scrotum.
   • The surgeon makes a small incision in the groin area, identifies the testicle, frees it from nearby tissues, and stitches it into the scrotum.
2. Fowler-Stephens Orchidopexy: Used when the testicle is higher in the abdomen.
   • This may be performed in two stages. The first involves clipping the blood supply to the testicle and relying on smaller blood vessels to supply it. In the second stage (months later), the testicle is moved to the scrotum.
3. Laparoscopic Orchidopexy: Used when the testicle is in the abdomen or its position is unclear.
   • Using a camera and small instruments, the surgeon locates and moves the testicle to the scrotum through small incisions.

Post-operative Recovery and Advice

1. Pain Management: Mild to moderate pain is expected, and pain relievers will be prescribed. Over-the-counter painkillers should be used as directed by the surgeon.
2. Wound Care: Keep the surgical site clean and dry. Follow the surgeon’s guidelines on when and how to bathe.
3. Swelling: Some swelling and bruising are common. Using a cold pack can help reduce swelling.
4. Activity: Refrain from vigorous activity and heavy lifting for a duration advised by the surgeon. Most children can return to school or normal activities within a week.
5. Underwear: Wear snug-fitting underwear or a scrotal support to minimize movement and support the testicles.
6. Follow-up: Schedule and attend all follow-up appointments to ensure proper healing and to monitor testicular position and function.
7. Seek Medical Attention: If you notice signs of infection (increased redness, swelling, pus), excessive bleeding, severe pain, or if the testicle ascends again.

Conclusion

Orchidopexy is a crucial procedure to correct an undescended testicle, reduce the risk of complications, and improve fertility potential. Proper understanding of the procedure and diligent post-operative care ensures a smooth recovery and optimal outcomes. Always consult with your healthcare provider for personalized advice and information.