Orchidopexy
What is an Orchidopexy?
An orchidopexy is a surgical procedure performed to move and permanently secure a testicle within the scrotum. It is most commonly used to treat an undescended testicle (cryptorchidism), but it is also performed as an emergency procedure to prevent recurrence after testicular torsion.
An undescended testicle occurs when one or both testicles fail to move into the scrotum before birth. If left untreated, this condition can increase the risk of fertility problems, testicular cancer, and testicular injury later in life. In adults and adolescents, orchidopexy may also be performed to secure the healthy testicle after torsion or in patients at increased risk of future torsion.
What are the Benefits of an Orchidopexy?
Orchidopexy provides several important long-term health benefits.
Benefits include:
- Positions the testicle permanently within the scrotum
- Improves the likelihood of normal testicular development
- May improve future fertility potential when performed early
- Reduces the risk of testicular torsion
- Makes examination and monitoring of the testicle easier
- May reduce the long-term risk of complications associated with undescended testicles
- Helps preserve testicular function following torsion when performed promptly
- Usually performed as a minimally invasive day-case procedure
When is an Orchidopexy Recommended?
Your urologist may recommend orchidopexy in several situations.
It is commonly performed for:
- An undescended testicle that has not descended naturally
- An ascending or retractile testicle requiring surgical fixation
- Following successful treatment of testicular torsion
- Prevention of torsion in the unaffected testicle after one side has twisted
- Testicles considered at increased risk of future torsion due to abnormal anatomy
Early treatment is generally recommended for undescended testicles, ideally before 12 to 18 months of age, although the procedure can also be performed in older children and adults when appropriate.
What does Preparation for an Orchidopexy Involve?
Before surgery, your surgeon will carry out a detailed assessment to determine the position of the testicle and plan the procedure.
Preparation may include:
- Physical examination
- Ultrasound imaging in selected cases
- Blood tests if required
- Review of current medications
- Fasting before general anaesthetic
- Discussion of the procedure, expected outcomes, and potential risks
- Consent from parents or guardians for paediatric patients
Patients undergoing emergency orchidopexy after testicular torsion will usually proceed directly to surgery without delay.
How is an Orchidopexy Performed?
Orchidopexy is performed under general anaesthetic and usually takes between 30 and 60 minutes, depending on the complexity of the procedure.
For an undescended testicle, the surgeon makes a small incision in the groin to locate and carefully free the testicle and spermatic cord from surrounding tissues. This allows sufficient length for the testicle to be positioned comfortably within the scrotum. A second small incision is made in the scrotum, where a pouch is created to securely hold the testicle. The testicle is then fixed in place using dissolvable stitches to prevent it from moving out of position.
If the testicle cannot be felt during examination, a laparoscopic (keyhole) approach may be used to locate it within the abdomen before completing the repair.
For patients undergoing orchidopexy after testicular torsion, the surgeon untwists the affected testicle, assesses its blood supply, and secures it within the scrotum. The opposite testicle is usually fixed during the same operation to reduce the risk of future torsion.
What to Expect during Recovery after an Orchidopexy?
Most patients return home on the same day as surgery.
During recovery, patients may experience:
- Mild swelling and bruising around the groin or scrotum
- Minor discomfort controlled with simple pain relief
- Temporary tenderness around the surgical site
- Return to light activities within several days
- Avoidance of strenuous exercise, cycling, contact sports, and heavy lifting for two to four weeks
- Follow-up appointments to monitor healing and testicular position
Children generally recover quickly and can usually return to school within a few days, depending on their comfort level.
What are the Risks and Complications of an Orchidopexy?
Orchidopexy is a safe and well-established procedure, but all surgery carries some potential risks.
Possible complications include:
- Bleeding or bruising
- Infection
- Wound healing problems
- Recurrence of an undescended testicle, although uncommon
- Injury to the blood supply of the testicle, which may affect testicular function
- Testicular shrinkage (atrophy), although this is uncommon
- Persistent discomfort during healing
- Rare recurrence of testicular torsion if fixation fails
Your urologist will explain the benefits and risks of orchidopexy and recommend the most appropriate treatment based on your individual condition, helping to preserve long-term testicular health and function.