Orchidopexy
What is orchidopexy?
Orchidopexy is a surgical procedure used to reposition a testicle into the correct location within the scrotum and secure it in place. It is most commonly performed to treat an undescended testicle, also known as cryptorchidism, but may also be used after testicular torsion or when a testicle is retractile or mobile. The procedure aims to ensure proper testicular function, reduce long-term risks and allow for easier examination and monitoring.
Why is it needed?
Orchidopexy may be recommended when a testicle has not descended into the scrotum by six to twelve months of age. It may also be advised when a testicle sits high, retracts frequently or does not remain in the scrotum.
The procedure is commonly performed after testicular torsion to secure the testicle and prevent the condition from recurring. Orchidopexy may also be recommended to reduce the risks of fertility problems, discomfort or testicular cancer, which can be associated with an undescended testicle. Positioning the testicle correctly in the scrotum allows easier long-term monitoring and examination.
What happens during the procedure?
The operation is performed under general anaesthesia. A small incision is made in the groin to locate the testicle and release it from surrounding tissues. A second small incision is made in the scrotum, where a space is created to position the testicle.
The testicle is then gently brought down into the scrotum and stitched in place. In some cases, if the testicle cannot be positioned safely during a single procedure, a planned two-stage approach may be used. Both incisions are closed using dissolvable stitches. The procedure generally takes between forty-five and sixty minutes, and most patients return home on the same day.
What are the alternatives?
Observation may be appropriate in young children with retractile testicles that move freely and may descend naturally over time. Hormone treatment may occasionally be used to encourage testicular descent, although it is less commonly recommended.
In older children or adults, orchidectomy — removal of a severely underdeveloped or non-functioning testicle — may be considered if the testicle cannot be corrected or if it carries long-term risks.
Potential risks and after effects
Orchidopexy is a safe and effective procedure, although some temporary effects are common. Pain or swelling may occur for several days. Mild bruising or small amounts of bleeding usually settle quickly. Infection may develop in a small number of cases and may require antibiotics.
In a small proportion of individuals, the testicle may move back up after the operation, requiring further surgery. Rarely, injury to the blood supply of the testicle may occur and can lead to shrinkage. Scrotal asymmetry may persist, with one testicle sitting slightly higher than the other. Fertility is generally improved when surgery is performed early, whereas delay may increase the risk of subfertility.
After the procedure
Following surgery, supportive underwear or a scrotal support can provide comfort. Regular pain relief may be taken as needed. The wound should be kept clean and dry, and showering is usually acceptable after twenty-four hours.
Strenuous exercise, heavy lifting, cycling and contact sports should be avoided for around four weeks. Mild swelling or bruising may last for one to two weeks. Medical advice should be sought if fever, redness or increasing discomfort occurs.
Follow-up care
A review is usually arranged within four to six weeks to assess healing and confirm that the testicle is positioned correctly. Long-term monitoring may be recommended to ensure normal testicular development and to check for re-ascent.
For those treated after testicular torsion, both testicles are monitored regularly. Routine testicular self-examination is encouraged from adolescence onwards to support ongoing testicular health.
Paediatric Procedures
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