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Orchiopexy—Laparoscopic

(Orchidopexy—Laparoscopic)

Pronounced: or-kee-o-pecks-ee
En Español (Spanish Version)

Definition | Reasons for Procedure | Possible Complications | What to Expect | Call Your Child’s Doctor

Definition

Testiscles should lower from the abdomen into the scrotum before birth. Some boys are born with one 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.

Undescended testes

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Reasons for Procedure

Orchiopexy is done to treat undescended testicles. The surgery may improve fertility. 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.

Possible Complications

Complications are rare, but no procedure is completely free of risk. Your doctor will review a list of possible complications, which may include:

  • Testicle move back up into groin after surgery
  • Damage to the testicle
  • Bleeding
  • Infection
  • Reaction to anesthesia
  • Injury to surrounding structures

What to Expect

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 one 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 two hours before the procedure.

General anesthesia will be used. It will keep your child asleep during the surgery and block pain.

Small keyhole incisions will be made in one 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. Stitches will hold the testicle in place. The stitches will dissolve on their own. All other incisions will also be closed with stitches.

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.

1 hour per testicle

Anesthesia prevents pain during the procedure. Medication will be given after the surgery to manage pain.

  • Your child will be monitored while he recovers from the anesthesia.
  • The nurse will give pain medications as needed.

When your child returns home, do the following to help ensure a smooth recovery:

  • Give medications to treat pain and prevent infection as directed.
  • Minor bleeding is normal. Care for the incisions as directed by the doctor.
  • If you child wears a diaper, change it often. Leave it off for short periods to reduce any irritation to the area.
  • Follow your doctor's direction for incision care. You may be asked to put an ointment or cream on the incisions.
  • Ask your doctor about when it is safe to bathe your child.
  • Engage in gentle play. Avoid tiring activities for a few weeks. Your child should avoid sitting on or riding a bicycle for about a week after the surgery.
  • Monitor your child for signs of pain. These may include irritability, trouble moving, sweating, or pale skin.

Be sure to follow the doctor’s instructions.

Call Your Child’s Doctor

After you leave the hospital, contact the doctor if any of the following occurs:

  • 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
  • Vomiting
  • Abdominal pain
  • Lack of energy
  • Loss of appetite

In case of an emergency, call for medical help right away.

RESOURCES:

American Academy of Pediatrics

http://www.healthychildren.org

American Family Physician

http://familydoctor.org

CANADIAN RESOURCES:

Canadian Pediatric Society

http://www.cps.ca

References:

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/what.php. Updated June 27, 2013. Accessed August 9, 2013.

Orchiopexy. Children’s Hospital and Clinics of Minnesota website. Available at: http://www.childrensmn.org/Manuals/PFS/Surg/018757.pdf. Updated March 2009. Accessed August 9, 2013.

Last reviewed August 2013 by Michael Woods, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.


 
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