Undescended Testicle (Cryptorchidism)

During pregnancy, a baby boy’s testicles develop inside the abdomen. Before birth, they descend into the scrotum through the inguinal canal. If the testicles do not reach the scrotum and remain in the inguinal canal, this condition is called undescended testicles. If a testicle stays in the abdominal cavity, it is referred to as cryptorchidism (from the Greek words kryptos meaning "hidden" and orchis meaning "testis"). One or both testicles may be undescended. This condition is usually detected at birth or during routine medical check-ups. In some cases, the testicle may continue to descend naturally within a few months after birth. However, if it has not reached the scrotum by six months of age, surgical correction (orchidopexy) is required.

What is Orchidopexy? 

Orchidopexy (testicular descent) is a surgical procedure performed under general anesthesia. During the surgery, the surgeon locates the testicle in the inguinal region and descends it into the scrotum. Orchidopexy can be performed in both early and later childhood. If your child has undescended testicles on both sides, both testicles can be operated on during the same procedure.

Depending on the position of the testicle, the surgery may be performed through an incision in the scrotum or through incisions in the inguinal region and scrotum. In the case of cryptorchidism, the testicle is located using a minimally invasive procedure, namely laparoscopic surgery. The laparoscopic procedure is performed through a small incision at the belly button and two smaller incisions on both sides of the abdomen, just below the belly button.

In most cases, only one operation is needed. However, if the testicles are located high in the abdomen (cryptorchidism), orchidopexy may require two separate laparoscopic surgeries, typically performed six months apart.

What If my child's testicle is not in the inguinal canal or abdomen? 

In some children, one of the testicles may not have developed. This means the child will only have one testicle, but it should not affect their ability to have children in adulthood, provided the other testicle is functioning normally.

What are the benefits of surgery? 

1. 1. A testicle in the abdomen or inguinal region may be prone to injury or twisting, and surgery can prevent these complications.
2. 2. The temperature in the abdomen is higher than in the scrotum, which can affect the growth and function (sperm production) of an undescended testicle, potentially leading to atrophy and decreased function.
3. 3. If the testicle is in the abdomen (cryptorchidism), changes that could develop in the testicle and indicate malignancy may go undetected.
4. 4. Surgery can boost a boy’s self-esteem. An empty or partially empty scrotum can cause feelings of insecurity about their body, especially during adolescence.

Are there any other treatment options? 

There are no other treatment options for undescended testicles.

What are the possible complications of Orchidopexy?

Complications from this surgery are rare, but they can include:

1. Bleeding from the wound
2. Wound infection: If your child's wound becomes red, painful, or if pus starts to drain, contact your general practitioner or surgeon who may prescribe antimicrobial therapy if necessary.
3. Testicle retracting into the inguinal canal: The testicle may sometimes return to the inguinal region. If this happens, another surgery will be needed.
4. Injury to the vas deferens: This should not affect your child’s growth and reproductive function if the opposite vas deferens is functional.
5. Injury to the testicular blood vessels: This will reduce blood flow to the testicle, leading to testicular atrophy. This should not affect your child’s growth and reproductive function if the opposite testicle is functioning normally.
6. Injury to intra-abdominal organs: During laparoscopic surgery, abdominal organs like the intestines or bladder may be injured. This is typically noticed during the procedure and corrected immediately.

The surgeon will discuss potential complications with you in detail and how they will be addressed.