Orchidopexy is a common surgical operation aimed at changing the attachment or position of the testicles in the body. This is done to avoid the risk of infertility, cancer, or testicular torsion. 

The testes are housed in the bursae. However, sometimes one or more testes do not “descend” well into the scrotum during the development of the genital tract. This is called “testicular ectopia”, a phenomenon which affects 3 to 4% of newborns each year. The operation is then prescribed in order to descend the testicle (s) into the bursae.

There is a second scenario in which the operation is recommended. The testes are connected to the abdomen by the vas deferens and the spermatic cord. Sometimes the attachments of the spermatic cord are not strong enough and the testicle is too mobile in the bursa. As a result, its ties sometimes twist (twisting of the spermatic cord), a painful condition. Orchidopexy is then performed to fix the canals on the testis.

The non-descent of a testicle in children poses several problems: 

• The testes are housed without the bursae in order to regulate heat. However, located in the abdomen where the temperature is higher, the testes cannot produce sperm. Studies find that not intervening before the age of two greatly increases the risk of infertility for adults. 
• If the testicles have not descended, their examination is made much more difficult if not impossible. Orchidopexy makes it possible to monitor the development of the testes and to detect possible cancer more quickly.

In adults, the operation is recommended for the same reasons and to prevent recurrence of testicular torsion.

In most cases, the non-descent of a testicle is monitored from birth and therefore observed in the child. Conversely, the torsion of the spermatic cord is very often an affection which concerns the adolescent or the adult man. It will then be necessary to prepare differently.

Preparing for orchidopexy in children 

After birth, the doctor feels the presence of both testicles in the scrotum. If one or both testicles have not descended within 6 to 12 months, you should prepare for the operation. 

As with any operation under anesthesia, a preoperative consultation will take place a few days before the operation. 

If the testicle is not palpable by the doctor (because it is too high in the body), he may request an ultrasound and an endocrine assessment.

In order to secure the child, you can bring him toys, soft toys, music etc.

On the day of the operation 

In 70% of cases, the testicle is palpable and orchidopexy is performed “on an outpatient basis”, that is to say a day hospitalization.

The surgeon will make an incision in order to lower the testicle into the bursa. This intervention lasts 20 to 40 minutes. The child can be brought home a few hours after the operation. 

In 30% of cases, an exploration of the abdominal cavity by laparoscopy is necessary to demonstrate the position of the testicle and its condition. If the doctor does not notice any abnormality, he performs orchidopexy. 

If, on the contrary, he notices an anomaly, he can remove it. At puberty, the addition of a prosthesis positioned in the bursa, for aesthetic purposes may be considered.

Preparing for orchidopexy in adults

In the case of excessive mobility of the testicle, the operation will be performed to prevent twisting of the spermatic cord. 

The operation can be performed under general anesthesia or under spinal anesthesia (lower body anesthesia).

As with any operation under anesthesia, a preoperative consultation will take place a few days before the operation. 

On the day of the operation

The intervention consists of an incision of the bursa and the attachment of the testicle to the supporting tissues by “stitching” points. It is also possible to place the testicle in a pocket created under the skin.

In the common forms, this intervention is considered to be not very painful and complications are rare. Detailed care during your stay in the hospital will be carried out on the wound.

The possible complications are:

• Bruising (transient induration of the bursa) may occur around the operated area. It normally regresses with rest and local care. In rare cases, the surgeon will be able to operate again.
• An infection related to surgery. 
• Delayed healing

If you notice any abnormal symptoms (fever, severe pain, swelling in the bursa, vomiting, absence or rarefaction of urine) consult your doctor.

To avoid for four weeks:

• The pool
• The bike
• The baths
• Contact sports

Note: as part of a testicular lowering operation, it is advisable to regularly palpate the child’s bursae to check that the testicle is still in place and of normal size (more or less the same size). than the second testis). From puberty, the patient can practice this palpation himself, provided he has learned the technique from the attending physician.