Description

As a baby grows in the womb, the testicles develop in the infant's abdomen. They drop down into the scrotum during the last months before birth.

In some newborns, however, one or both testicles do not move down into the correct position. About half of these cases will descend within the first year of life without medical treatment.

Undescended testicle repair surgery is recommended for patients whose testicles do not descend on their own.

The surgery is done while the child is asleep (unconscious) and pain-free under general anesthesia. The surgeon makes a cut in the groin, where most undescended testes are located.

After finding the cord that holds the testis in the scrotum, the surgeon unties it from the tissue around it so that the cord's full length is used. A small cut is made in the scrotum, and a pouch is created. The testicle is carefully pulled down into the scrotum, and stitched into place. Stitches are used to close any surgical cuts.

In some cases, the procedure can be done laparoscopically, which involves smaller surgical cuts.

Why the Procedure is Performed

This surgery is recommended for infants older than 1 year whose testicles have not descended into the scrotum (cryptorchidism).

An undescended testicle is different from a "retractile" testicle, in which the testicle drops into the scrotum and then pulls back. Retractile testicles do not need surgery.

Risks

Risks for any anesthesia are:

• Reactions to medications
• Problems breathing

Risks for any surgery are:

• Bleeding
• Infection

After the Procedure

Undescended testicle repair is successful in most cases. A small percentage of men will have fertility problems. (See: Infertility)

Men who have had undescended testicles should do monthly self-exams throughout their lives for possible tumors. People with undescended testes have higher rates of testicular cancer than those with normal testicle development, even if they have a fully descended testicle on the other side.

Outlook (Prognosis)

The surgery may be done on an outpatient basis. Bed rest is recommended for the first 2 - 3 days. Avoid strenuous activity, including bicycling, for at least 1 month to allow the testicle to heal in its new position.

Alternative Names

Orchidopexy; Inguinal orchidopexy; Orchiopexy; Repair of undescended testicle; Cryptorchidism repair

References

Schneck FX, Bellinger MF. Abnormalities of the testes and scrotum and their surgical management. In: Wein AJ, ed. Campbell-Walsh Urology. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 127.

Elder JS. Disorders and anomalies of the scrotal contents. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 545.

Updated: 4/3/2012

Reviewed by: Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington School of Medicine; and Scott Miller, MD, Urologist in private practice in Atlanta, Georgia. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.