Orchiopexy is a surgical procedure to correct an undescended testicle (a testicle that has failed to move into the scrotum). The surgeon relocates the testicle from the abdomen or groin into the scrotum and secures it in place.

Reasons for the Procedure

1. Natural Development Issue

   • Testicles form in the abdomen during fetal development.

   • They typically descend into the scrotum before birth or within the first few months of life.

   • If one or both testicles remain undescended (cryptorchidism), surgery may be needed.

2. Potential Risks Without Treatment

   • Infertility: Higher body temperature in the abdomen can impair sperm production.

   • Testicular Cancer: Undescended testicles have a higher cancer risk later in life.

   • Testicular Torsion: The testicle may twist, cutting off blood flow (medical emergency).

   • Hernia Risk: Often associated with an undescended testicle.

Surgical Procedure Step-by-Step

1. Anesthesia

   • Usually general anesthesia (patient is fully asleep).

   • Sometimes local anesthesia with sedation (older patients).

2. Locating the Testicle

   • If the testicle is in the groin: A small incision is made there.

   • If the testicle is in the abdomen: A laparoscope (tiny camera) may be used to find it.

3. Mobilizing the Testicle

   • The surgeon carefully frees the testicle from surrounding tissues.

   • The spermatic cord (which supplies blood and connects to the testicle) is gently stretched to allow proper positioning.

4. Fixing the Testicle in the Scrotum

   • A small incision is made in the scrotum.

   • The testicle is placed into the scrotum and stitched into place (pexy = fixation).

   • Sometimes, a temporary stitch holds it in position for healing.

5. Closing the Incisions

   • Absorbable stitches are typically used (no need for removal).

Recovery Process

• Immediately After Surgery

  • Mild groin/scrotal swelling and discomfort (managed with pain relievers).

  • Most children go home the same day.

• First Few Days

  • Avoid baths (showering is usually OK after 1-2 days).

  • Light activity only—no running, climbing, or rough play.

• Follow-Up

  • A check-up ensures the testicle stays in place.

  • Rarely, a second surgery is needed if the testicle moves back.

Success Rate & Long-Term Outlook

• Highly Effective: Over 90% success rate when performed in early childhood.

• Fertility: If done before age 1-2, most boys develop normally.

• Cancer Risk: Reduced but not eliminated—regular self-exams are advised later in life.

Key Points to Remember

• Best Timing: Surgery is recommended between 6-18 months old for best results.

• Not Painful Afterward: Discomfort is usually mild and short-lived.

• Common Procedure: One of the most frequent surgeries in pediatric urology.