A testicle not seen or felt in the scrotum is the most important sign of an undescended testicle. Fetuses develop their testes in the abdomen. Testicles of a normal fetus descend from the abdomen into the scrotum through a tube-like passageway in the groin (inguinal canal). This procedure ceases or slows when a testicle is undescended.

The reason for an undescended testicle is unknown. Multiple factors such as genetics, pregnancy, and certain environmental factors can disrupt hormones, physiology, and nerve activity that affect testicular development.

Several factors may result in an undescended testicle in a newborn. These risk factors are:

• An underweight baby
• Birth before the due date
• An undescended testis or other genital development problems in the family
• Fetuses with Down syndrome or abnormal abdominal walls can restrict growth.
• Pregnant women who drink alcohol
• Mother smoking cigarettes or has been exposed to passive smoking

Surgery to reposition an undescended testicle into the scrotum is known as orchiopexy or orchidopexy. Most babies require surgery by the time they are 18 months old. A pediatric surgeon or a specialist in children’s urology (pediatric urologist) performs the surgery. Older boys may also undergo orchiopexy. The procedure may be performed on male adolescents and adults with undescended testicles.

Depending on where the testes are located, a small incision may be made in the scrotum, the groin, or the abdomen. The surgeon can then access the testicle and move it into the scrotum. Sometimes laparoscopy is performed to move undescended testicles. The procedure may be performed in the inguinal canal or the abdomen. The procedure is performed under general anesthesia in both cases.

The procedure usually only requires one surgery. But sometimes, when the testicles are in the abdomen, your child’s urologist may recommend two separate operations within a gap of several months.

In cases where urologists cannot find any testicles in the scrotum after birth, they might recommend further tests to check if the testicles are undescended or not present at all. Leaving absent testicles undiagnosed and untreated can lead to severe medical problems shortly after birth. Ultrasounds and MRIs are not recommended to diagnose an undescended testicle.

Your child will be given a general anesthetic so he sleeps during the operation. The doctor will then make a small incision (cut) at the top of your child’s leg, called the groin. They will ease the testicle swiftly into the scrotum. The groin will be incised twice, once on each side, if both testicles need descending. Normally, each testicle takes about an hour to remove.

An orchiopexy is usually performed as an outpatient procedure. As a result, the procedure takes place the same day the child is admitted. Your baby needs to rest for a short while after the surgery. You can probably take your baby home the same day after his operation. He does not need to stay in the hospital overnight.

Before the surgery, your baby should not be given anything to drink or eat. Additionally, food and water instructions will vary based on your baby’s age.

Babies normally experience dizziness, nausea, or irritability after surgery. Some babies wake up crying. However, once the anesthesia wears off, these effects will begin to fade too.

Ask your child to avoid games, sports, and rough play, all activities that risk injury to the genitals. This should be followed for at least 2 weeks. It is recommended to keep the area where the incision was made clean and dry. In most cases, you may bathe your baby the day after the wound heals unless there is a waterproof dressing. Usually, the follow-up exam is scheduled within 2 to 3 months of the procedure.

A surgery (Orchiopexy) is performed to reposition the undescended testicle in the scrotum.

• ● Besides helping prevent infertility, scrotal placement may decrease the risk of testicular cancer.
• ● Orchidopexy makes it easier to diagnose testicular cancer if it occurs.
• ● Surgery can enhance your child’s self-esteem. A partially or completely defunct scrotum can be embarrassing for young boys, particularly in their teenage years.
  ● The surgery reduces the risk of testicular injury. Sports injuries and discomfort caused by seat belts may easily affect males if their testicles are in the groin area.

Orchiopexy is a safe and reliable procedure that carries a few to zero risks. It is best to choose a surgeon and medical staff trained and experienced at handling children and their special needs.

At Smiles Institute of Gastroenterology LLP, we work with experienced urologists available 24/7 to help with your medical needs. If you are worried about any problems before or after your child’s surgery, or if you would like more information, please ask our medical staff, who will be happy to assist.