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Operation to bring down testicles (orchidopexy)

What is an undescended testicle?

An undescended testicle is a testicle which is not properly in the scrotum (ball bag). Testicles form at the back of the tummy and during development, gradually move down into the scrotum. They may do not ‘drop’ completely or the testicle may drop into an abnormal position outside the scrotum.

Why does this operation need to be done?

The testicle is designed to work best at a slightly lower temperature than the rest of the body. This is why the scrotum hangs outside of the body. There is evidence of changes in the testicle as early as 2 years of age, which is why we try to bring the testicle down before this age.

In some older boys the testicle is in a normal position to start with, and then goes up. With all testicles it is important that the testicle is in the scrotum before puberty or there is a high risk of the testicle not producing sperm properly.

What would happen if nothing was done?

If left outside the scrotum the testicle would not grow normally. The sperm that would eventually be produced would be abnormal and the testicle will likely be infertile. The testicle is also more likely to twist (and die off) or to get damaged if it was left in the groin.

What does the operation involve?

The operation is done under a general anaesthetic and usually involves a small cut in a skin crease in the groin area and another cut across the scrotum. Through the cut, the testicle is found and freed up so the cord is long enough for it to come down into the scrotum. The testicle is then fixed in a pouch just under the skin made through the cut in the scrotum. The stitches used are dissolving ones and do not need to be taken out later.

In some older boys where the testicle is not too far away from the scrotum, the operation may be possible through a single incision in the scrotum.

What will happen afterwards and what will the recovery be like?

It is usually a quick recovery from the operation, especially in younger boys.

The area will be sore for a couple of days and are usually back to normal activity within a few days. The pain can be managed with simple paracetamol.

There is always some bruising and thickening in the scrotum. The bruising will settle fairly quickly but the thickening may take a few months to resolve. Older boys may experience more discomfort and this group will need to stay away from active sports (except swimming) for 2 to 3 weeks.

What complications can occur from the surgery?

There is a small risk of damaging the blood supply to the testicle during the operation. If this happens the testicle will not grow or may shrink. This happens in about 1 in 50 cases.

The tube that carries the sperm may also be damaged although this is very uncommon.

Later on, the testicle may be pulled back out of the scrotum by scar tissue and require further surgery to move it back down again.

A wound infection can also happen which may need antibiotics to treat.

Will there need to be any medical check up after surgery?

The wounds heal very well and do not always need to be checked. However the position and size of the testicle do need to be checked 6 to 12 months after surgery in the outpatients department.

Further resources

Please read our resource for more information about risks of anaesthetics.

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Disclaimer

Please note: this is a generic information sheet relating to care at Sheffield Children’s NHS FT. These details may not reflect treatment at other hospitals. This information is not intended as a substitute for professional medical care. Always follow your healthcare professionals’ instructions. If this resource relates to medicines, please read it alongside the medicine manufacturer’s patient information leaflet. If this information has been translated into another language from English, efforts have been made to maintain accuracy, but there may still be some translation errors. If you are unsure about any of the guidance in this resource or have specific questions about how it relates to your child, always ask your healthcare professional for further advice.

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Julian Roberts

NHS

Western Bank
Sheffield
S10 2TH

United Kingdom

Switchboard: 0114 271 7000

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