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Orchidopexy
What is an undescended testicle?
When the testicles, (one or both) cannot be felt in the scrotum, they are called undescended. As a boy baby is growing in the womb, the testicles are developing in the abdomen. They travel down a tunnel called the inguinal canal into the scrotum. When the testicle is not in normal position by six months to one year of age, it should be surgically fixed.
How is undescended testis diagnosed?
An undescended testicle is diagnosed by physical exam. An undescended testicle cannot be pulled down into the scrotum or does not stay down easily when the muscle is relaxed.
How is the decision made that surgery is needed?
The testicle is monitored up until 6-12 months of age. The decision to intervene surgically is made at this time.
What can I expect from surgery?
The operation is done on an outpatient basis. This means your child is brought to the hospital on the day of surgery and then goes home a few hours after he recovers.
Bring for your son for the day of surgery:
- A variety of favorite toys, music tapes, or books to encourage quiet time.
- A special toy or security blanket that may help to comfort your child.
- Extra pacifiers or teething toys to help soothe your baby.
- A change of clothes and loose clothes to wear home from the hospital.
- Snacks or money to buy yourself a meal. Please do not eat in front of your child.
It is best, when possible, to make arrangements for siblings to stay at home on the day of surgery, in order for you to participate fully in your child’s care.
When will my child be able to go home?
Your child will go home the same day of surgery, usually a few hours after he recovers from anesthesia. Plan on a total of 3-5 days off work including the surgical day. This will allow for 2 quiet days after the operation.
What kind of care is needed at home after surgery?
There is no limitation on the activity of a baby under 18 months of age.
Toddlers and older boys should not play with straddle toys for 10 days and school age boys should not participate in contact sports for four weeks.
Care of the incision:
There will be an incision in the inguinal skin crease. Reinforced sticky bandages may be applied. A clear plastic dressing or a gauze dressing will cover the incision. The clear plastic dressing is waterproof. Remove the dressings according to your surgeon’s instructions. Expect bruising and swelling for at least 3-5 days.
If the operation is performed through the scrotum, a dissolvable suture is present that will fall out as the healing progresses.
Activity limitations:
- 0-8 months Normal activity for age.
- 8months-21/2 years: Be careful of toddler accidents for 2 weeks
- 21/2 years-12 years Quiet supervised play for 24-48 hours. No running, contact sports, or vigorous activity for 4 weeks.
Feeding:
Your son may have his regular diet, however his appetite may not be normal for 24-36 hours. If so, give frequent small amounts of clear liquids (juice, soda, sugar water). Some children become constipated after surgery. Give plenty of fluids to prevent this. Your child shouldn’t go more than 48 hours without a bowel movement.
Bathing:
Keep the diaper area clean and dry. Bathe your child according to the surgeon’s instructions.
Pain Management:
Give medicine around the clock for the first 24-48 hours and as needed after that for 3-4 days. Please call if your child is uncomfortable. Some children need more medicine than others.
What should I call the surgery team for?
Call the office if you have any questions or if there is:
- Bleeding or drainage at the incision.
- Fever above 101 F.
- Vomiting
- Not peeing or fewer wet diapers than usual.
When can my child return to school or daycare?
Your child must be closely supervised to avoid accidents for 14 days. He may return to school 48-72 hours after surgery. He should not have physical education classes for 4 weeks. Ask us for an excuse note for school.
What are the long term consequences?
Less than 1% of the population develops complications such as injury to the testicle, bleeding or infection.
There is a risk that cellular damage has been done to the testicle while in the warm abdominal environment. One reason to bring the testicle down into the scrotum is to be able to examine its size and consistency as he grows. Your primary care provider will help you with this and when your son is older, he should be taught to examine his testicles.
Will this affect growth and development?
Growth and development of the testicle may be impaired if it is not brought down into normal position in the scrotum. The testicle can not develop normally in the warm environment of abdomen.
Please reproduce and distribute this sheet to your surgery families. This teaching sheet can also be downloaded at www.APSNA.org.
Copyright 2006, Mary Ellen Connolly. Copied with permission by Jones and Bartlett Publishers, Sudbury, MA.