The testicles of most baby boys are descended at birth into the scrotal sac. About 3% of boys will have hidden or undescended testicles. The testicle can often be felt in the inguinal canal in the area of the groin. It is highly unlikely that the baby's testicles will descend into their proper place after the first six months of life, and certainly after one year of age the testicles will need to be surgically brought into position. The surgery to bring down the testicles into the scrotum is called orchiopexy (orchio = testicle, pexy = stitch into place) and is perforemd as an outpatient procedure under general anesthesia.
The procedure is performed through a small incision in the groin area where the testicle is freed from the surrounding tissue and brought into position in the scrotum. A tiny incision is then made at the bottom of the scrotal sac where the testicle is sutured into place. This prevents the testicle from moving back upward through the canal. If the urologist is not able to feel the testicle, it may be necessary to use a laparoscope to locate the testicle. It may be located in the abdomen or absent altogether.
It is important for the child's future health that the testicle is brought down into place. Fertility in adulthood may be improved by early correction. Adult men also need to perform testicular self-examination to detect testicular cancer in much the same way adult women perform breast self-examination. If the testicle remains in the body cavity it is not accessible for examination, and cancerous tumors may easily go undetected. Testicular self-examination is critical for the future.
One or both testicles may be undescended and the surgery to bring them into place will usually require 1-2 hours in the operating room. Potential complications include the loss of blood flow to the testicle. The Pediatric Urologist performs close to 100 orchiopexys each year at the North Carolina Children's Hospital at UNC, and works closely with the Pediatric Anesthesiologists and Pediatric Nurses to provide a coordinated and sensitive approach that will meet the unique needs of children undergoing a surgical procedure.
For further information please contact the Department of Pediatric Urology at the North Carolina Children's Hospital, University of North Carolina at (919) 966-8054.