Name of the Procedure:

Orchiopexy
Common name(s): Testicle fixation
Technical/medical terms: Orchiopexy, orchidopexy

Summary

Orchiopexy is a surgical procedure to correct undescended testicles, a condition where one or both of the testicles fail to move into the scrotum. The surgery involves relocating the testicle to its proper position and securing it in place.

Purpose

Medical Condition: Cryptorchidism (Undescended testicle)
Goals/Outcomes: To move the testicle(s) to the scrotum to improve fertility potential, lower the risk of testicular cancer, and prevent potential damage or torsion.

Indications

Symptoms/Conditions:

• Palpable or non-palpable undescended testicle(s)
• Retractile testicle(s)
• Ectopic testicle(s)

Patient Criteria:

• Generally performed on infants or young children, but can also be done in older children and adults if required.

Preparation

Pre-procedure Instructions:

• Fasting usually required from midnight prior to the day of surgery
• Adjustments or stoppage of certain medications as advised by the doctor

Diagnostic Tests/Assessments:

• Physical examination
• Ultrasound or MRI if the testicle is not palpable

Procedure Description

1. Anesthesia: General anesthesia is administered.
2. Incision: A small incision is made in the groin or scrotum.
3. Mobilization: The undescended testicle is located and freed from surrounding tissues.
4. Relocation: The testicle is gently moved into the scrotum.
5. Fixation: The testicle is secured into place using sutures.
6. Closure: The incision is closed with sutures or surgical glue.

Tools/Equipment: Surgical instruments, sutures, possibly laparoscopic tools if minimally invasive.

Duration

Typically takes between 30 minutes to 1 hour.

Setting

Performed in a hospital or surgical center, usually as an outpatient procedure.

Personnel

• Pediatric or general surgeon
• Anesthesiologist
• Operating room nurses

Risks and Complications

Common Risks:

• Infection
• Bleeding
• Swelling
• Discomfort at the incision site

Rare Risks:

• Testicle reascension (moving out of the scrotum again)
• Testicular atrophy (shrinkage)
• Reaction to anesthesia

Management of Complications: Monitoring, medications, or additional surgery if necessary.

Benefits

Expected Benefits:

• Proper positioning of the testicle
• Improved chances of fertility
• Reduced risk of testicular cancer
• Prevention of potential damage or torsion

Realization Timeframe: Immediate anatomical correction, with long-term benefits seen as the child grows.

Recovery

Post-procedure Care:

• Pain management, usually via over-the-counter pain relievers
• Care for the surgical site to prevent infection

Recovery Time: Typically 1-2 weeks for most activities, with full recovery in a few months.

Restrictions/Follow-up:

• Avoid strenuous activities for a few weeks
• Follow-up appointment to monitor healing

Alternatives

Other Treatments:

• Hormonal therapy (less commonly used)
• Watchful waiting in certain cases (e.g., retractile testicle)

Pros and Cons:

• Hormonal therapy less effective for permanent correction
• Watchful waiting can delay treatment benefits

Patient Experience

During the Procedure: Under general anesthesia, so the patient is asleep and should not feel anything.

Post-procedure:

• Mild to moderate discomfort at the incision site
• Swelling and slight bruising around the scrotum
• Pain managed with medication
• Gradual resumption of normal activities within a few weeks