Orchiopexy





Definition

Orchiopexy is a procedure in which a surgeon fastens an undescended testicle inside the scrotum, usually with absorbable sutures. It is done most often in male infants or very young children to correct cryptorchidism, which is the medical term for undescended testicles. Orchiopexy is also occasionally performed in adolescents or adults, and may involve one or both testicles. In adults, orchiopexy is most often done to treat testicular torsion, which is a urologic emergency resulting from the testicle's twisting around the spermatic cord and losing its blood supply.

Other names for orchiopexy include orchidopexy, inguinal orchiopexy, repair of undescended testicle, cryptorchidism repair, and testicular torsion repair.


Purpose

To understand the reasons for performing an orchiopexy in children, it is helpful to have an outline of the normal pattern of development of the testes in a male infant. The gubernaculum is an embryonic cord-like ligament that attaches the testes within the inguinal (groin) region of a male fetus up through the seventh month of pregnancy. Between the 28th and the 35th week of pregnancy, the gubernaculum migrates into the scrotum and creates space for the testes to descend. In normal development, the testes have followed the gubernaculum downward into the scrotum by the time the baby is born. The normal pattern may be interrupted by several possible factors, including inadequate androgen (male sex hormone) secretion, structural abnormalities in the boy's genitals, and defective nerves in the genital region.

Orchiopexy is performed in children for several reasons:

  • To minimize the risk of infertility. Adult males with cryptorchidism typically have lower sperm counts and produce sperm of poorer quality than men with normal testicles. The risk of infertility rises with increasing age at the time of orchiopexy and whether both testicles are affected. Men with one undescended testicle have a 40% chance of being infertile; this figure rises to 70% in men with bilateral cryptorchidism.
  • To lower the risk of testicular cancer. The incidence of malignant tumors in undescended testes has been estimated to be 48 times the incidence in normal testes. Men with cryptorchidism have a 10% chance of eventually developing testicular cancer.
  • To lower the risk of traumatic injury to the testicle. Undescended testicles that remain in the patient's groin area are vulnerable to sports injuries and pressure from car seat belts.
  • To prevent the development of an inguinal hernia. An inguinal hernia is a disorder that occurs when a portion of the contents of the abdomen pushes through an abnormal opening in the abdominal wall. It is likely to occur in a male infant with cryptorchidism because a sac known as the processus vaginalis, which connects the scrotum and the abdominal cavity, remains open after birth. In normal development, the processus vaginalis closes shortly after the testes descend into the scrotum. If the sac remains open, a section of the child's intestine can extend into the sac. It may become trapped (incarcerated) in the sac, forming what is called a strangulated hernia. The portion of the intestine that is trapped in the sac may die, which is a medical emergency.
  • To prevent testicular torsion in adolescence.
  • To maintain the appearance of a normal scrotum. Orchiopexy is considered a necessary procedure for psychological reasons, as boys with only one visible testicle are frequently subjected to teasing and ridicule after they start school.

The primary reason for performing an orchiopexy in an adolescent or adult male is treatment of testicular torsion, rather than cryptorchidism. Testicles that have not descended by the time a boy reaches puberty are usually removed by a complete orchiectomy .


Demographics

Cryptorchidism

Cryptorchidism is the most common abnormality of the male genital tract, affecting 3–5% of full-term male infants and 30–32% of premature male infants. In most cases, the condition resolves during the first few months after delivery; only 0.8% of infants over three months of age still have undescended testicles. Because of the potentially serious consequences of cryptorchidism, however, doctors do not advise watchful waiting once the child is over six months old. Undescended testicles

An orchiopexy is used to repair an undescended testicle in childhood. An incision is made into the abdomen, the site of the undescended testicle, and another is made in the scrotum (A). The testis is detached from surrounding tissues (B) and pulled out of the abdominal incision attached to the spermatic cord (C). The testis is then pulled down into the scrotum (D) and stitched into place (E). (Illustration by Argosy.)
An orchiopexy is used to repair an undescended testicle in childhood. An incision is made into the abdomen, the site of the undescended testicle, and another is made in the scrotum (A). The testis is detached from surrounding tissues (B) and pulled out of the abdominal incision attached to the spermatic cord (C). The testis is then pulled down into the scrotum (D) and stitched into place (E). (
Illustration by Argosy.
)
rarely come down into the scrotum of their own accord after that age.

Cryptorchidism is a frequent occurrence in prune belly syndrome (PBS) and a few other genetic disorders characterized by structural abnormalities of the genitourinary tract.

No variation in the incidence of cryptorchidism among different racial and ethnic groups has been reported.


Testicular torsion

Most American males suffering from testicular torsion are below age 30, with the majority between the ages of 12 and 18. The peak ages for an acute episode of testicular torsion are the first year of life and age 14. Testicular torsion occurs on the left side of the body slightly more often than on the right side, about 52% versus 48% of cases.


Description

Cryptorchidism

Some orchiopexies in children are relatively simple procedures; however, others are complicated by the location of the undescended testicle. In general, an orchiopexy for an undescended testicle that lies in front of the scrotum or just above it is a less complicated operation than one done to treat a non-palpable testicle. The procedure is usually done under general anesthesia.

If the undescended testis is in the groin area, the surgeon will make a small incision in the groin and a second small incision in the scrotum. The testis is moved downward from the groin without complete separation from the gubernaculum. It is then placed inside a small pouch created by the surgeon between the skin of the scrotum and a layer of muscle in the scrotum called the dartos muscle. The testicle is held in place with sutures that are eventually absorbed by the body.

The Fowler-Stephens technique is often used when the undescended testicle is located high above the scrotum or in the abdomen. It may be done in two stages scheduled several months apart. In the first stage, the surgeon moves the testicle downward and attaches it temporarily to the inside of the thigh. In the second stage, the testicle is transferred into the scrotum itself and sutured into place.

A third type of orchiopexy is called testicular auto-transplantation. The surgeon removes the undescended testicle completely from its present location and re-implants it in the scrotum by reattaching its surrounding tissues and blood vessels to nearby blood vessels. This technique minimizes the risk of an inadequate blood supply to the re-implanted testicle.

Testicular torsion

An orchiopexy done to treat testicular torsion is usually done under general or epidural anesthesia. The surgeon makes an incision in the patient's scrotum and untwists the spermatic cord. The affected testicle is inspected for signs of necrosis, or tissue death. If too much tissue has died due to loss of blood supply, the surgeon will remove the entire testicle. If the tissue appears to be healthy, the surgeon sutures the testicle to the wall of the scrotum and then closes the incision. In most cases, the surgeon will also attach the unaffected testicle to the scrotal wall as a preventive measure.


Diagnosis/Preparation

Cryptorchidism

The diagnosis of cryptorchidism is usually made when a pediatrician examines the newborn baby, although the condition can occur at any time before the boy reaches puberty. The first stage in diagnosis is an external physical examination of the child's genitals. If either testicle does not appear to be in the scrotum, the doctor will palpate, or touch, the groin area and abdomen to determine whether a testicle can be felt in any of those locations. If the testicle can be felt, the doctor will decide on the basis of its location whether it is an undescended testicle, a so-called ectopic testicle, or a retractile testicle. An ectopic testicle is one that has developed in a location outside the normal path of development in the inguinal canal. Ectopic testicles are most often discovered along the inner part of the thigh near the groin, at the base of the penis, or below the scrotum in the perineum (the area between the scrotum and the rectum). A retractile testicle is one that is readily pulled back out of the scrotum by an overly sensitive reflex called the cremasteric reflex; it is not a genuinely undescended testicle. It is important for the doctor to distinguish a retractile testicle from genuine cryptorchidism because retractile testicles do not need surgical treatment. At this point in the diagnostic workup, a general pediatrician will often consult a specialist in pediatric urology.

In about 20% of male infants with cryptorchidism, the missing testicle cannot be felt at all. It is known as a non-palpable testicle. The child may be given a hormone challenge test to help determine whether the testicle is located in the abdomen or whether it has failed to develop fully. If the testosterone level in the blood rises in response to the test, the doctor knows that there is a testis present somewhere in the child's body. In other cases, the testis has atrophied, or shriveled up due to an inadequate blood supply before birth. If neither testicle can be felt, the child should be examined further for evidence of inter-sexuality. The doctor may order an ultrasound to check for the presence of a uterus, particularly if the child's external genitals are ambiguous in appearance.

Surgery is the next step in searching for a non-palpable testicle. The surgeon may perform either an open inguinal procedure or a laparoscopic approach. In an open inguinal exploration, the surgeon makes an incision in the child's groin; if nothing is found, the incision may be extended into the lower abdomen. In a laparoscopic approach, the surgeon uses an instrument that looks like a small telescope with a light attached in order to see inside the groin or the abdominal cavity through a much smaller incision. If the surgeon is able to find the testicle, he or she may then proceed directly to perform an orchiopexy.


Testicular torsion

Testicular torsion is usually diagnosed in the emergency room. The doctor will usually suspect testicular torsion on the basis of sudden onset of severe pain on one side of the scrotum; it is unusual for pain to develop gradually in this disorder. The patient's history often indicates recent hard physical work, vigorous exercise , or trauma to the genital area; however, testicular torsion can also occur without any apparent reason. Other symptoms may include swelling of the scrotum, blood in the semen, nausea and vomiting, pain in the abdomen, and fever. A few patients feel the need to urinate frequently. When the doctor examines the patient's scrotum, the affected testicle is usually enlarged and is painful when the doctor touches it. It usually lies higher in the scrotum than the unaffected testicle and may be lying in a horizontal position.

Since testicular torsion is a medical emergency, most doctors will not risk permanent damage to the testicle by taking the time to perform imaging studies. If the diagnosis is unclear, however, the doctor may order a radionuclide scan or a color Doppler ultrasound to determine whether the blood flow to the testicle has been cut off. The patient will be given a mild pain medication and referred to a urologist for surgery as soon as possible.


Aftercare

Cryptorchidism

Aftercare in children depends partly on the complexity of the procedure. If the child has an uncomplicated orchiopexy, he can usually go home the same day. If the surgeon had to make an incision in the abdomen to find a non-palpable testicle before performing the orchiopexy, the child may remain in the hospital for two or three days. The doctor will usually prescribe a pain medication for the first few days after the procedure.

After the child returns home, he should not bathe until the day after surgery. In addition, he should not ride a bicycle, climb trees, or do anything else that requires straddling for two or three weeks. An older boy should avoid sports or rough games that might result in injury to the genitals until he has a post-surgical checkup.

Most surgeons will schedule the child for a checkup one or two weeks after the orchiopexy, with a second checkup three months later.


Testicular torsion

Aftercare is similar to that for orchiopexy in a child. The area around the incision should be washed very gently the next day and a clean dressing applied. Medication will be prescribed for postoperative pain. The patient is advised to rest at home for several days after surgery, to remain in bed as much as possible, to drink extra fluids, and to elevate the scrotum on a small pillow to ease the discomfort. Vigorous physical and sexual activity should be avoided until the pain and swelling go away.


Risks

Cryptorchidism

The risks of orchiopexy in treating cryptorchidism include:

  • infection of the incision
  • bleeding
  • damage to the blood vessels and other structures in the spermatic cord, leading to eventual loss of the testicle
  • failure of the testicle to remain in the scrotum (This problem can be repaired by a second operation.)
  • difficulty urinating for a few days after surgery

Testicular torsion

The risks of orchiopexy as a treatment for testicular torsion include:

  • infection of the incision
  • bleeding
  • loss of blood circulation in the testicle leading to loss of the testicle
  • reaction to anesthesia

Normal results

In a normal orchiopexy, the testicle remains in the scrotum without re-ascending. If the procedure has been successful, there is no damage to the blood vessels supplying the testicle, no loss of fertility, and no recurrence of torsion.

Morbidity and mortality rates

Cryptorchidism

Orchiopexy is most likely to be successful in children when the undescended testicle is relatively close to the scrotum. The rate of failure for orchiopexy performed as a treatment for cryptorchidism is 8% if the testicle lies just above the scrotum; 10–20% if the testicle is located in the inguinal canal; and 25% if the testicle lies within the abdomen.


Testicular torsion

The mortality rate for orchiopexy in adults is very low because almost all patients are young males in good health. The procedure has a 99% rate of success in saving the testicle when the diagnosis is made promptly and treated within six hours. After 12 hours, however, the rate of success in saving the testicle drops to 2%. The average rate of testicular atrophy following orchiopexy for testicular torsion is about 27%.


Alternatives

Cryptorchidism

Hormonal therapy using gonadotropins to stimulate the production of more testosterone is effective in some children in causing the testes to descend into the scrotum without surgery. This approach, however, is usually successful only with undescended testes that are already close to the scrotum; its rate of success ranges from 10–50%. Undescended testes that are located higher almost never respond to hormonal therapy. In addition, treatment with hormones has several undesirable side effects, including aggressive behavior.

Some surgeons will, however, prescribe hormonal treatment before an orchiopexy in order to increase the size of the undescended testis and make it easier to identify during surgery.


Testicular torsion

Pain caused by testicular torsion can be relieved temporarily by manual detorsion. To perform this maneuver, the doctor stands at the patient's feet and gently rotates the affected testicle toward the outside of the patient's body in a sidewise direction. Manual detorsion is effective in relieving pain in 30–70% of patients; however, it is not considered an alternative to orchiopexy in preventing a recurrence of the torsion or loss of the testicle.

See also Orchiectomy ; Urologic surgery .


Resources

BOOKS

"Congenital Anomalies: Renal and Genitourinary Defects." Section 19, Chapter 261 in The Merck Manual of Diagnosis and Therapy, edited by Mark H. Beers and Robert Berkow. Whitehouse Station, NJ: Merck Research Laboratories, 1999.

PERIODICALS

Baker, L. A., et al. "A Multi-Institutional Analysis of Laparoscopic Orchidopexy." BJU International, 87 (April 2001): 484–489.

Chang, B., L. S. Palmer, and I. Franco. "Laparoscopic Orchidopexy: A Review of a Large Clinical Series." BJU International, 87 (April 2001): 490–493.

Docimo, S. G., R. I. Silver, and W. Cromie. "The Undescended Testicle: Diagnosis and Management." American Family Physician, 62 (November 1, 2000): 2037–2044, 2047–2048.

Dogra, Vikram S., and Hamid Mojibian. "Cryptorchidism." eMedicine, June 21, 2002 [April 4, 2003]. http://www.emedicine.com/radio/topic201.htm .

Franco, Israel. "Prune Belly Syndrome." eMedicine, August 24, 2001 [April 4, 2003]. http://www.emedicine.com/med/topic3055.htm .

Jawdeh, Bassam Abu, and Samir Akel. "Cryptorchidism: An Update." American University of Beirut Surgery, (Summer 2002) [April 3, 2003]. http://www.staff.aub.edu.lb/~websurgp/sc0a.html .

Nair, S. G., and B. Rajan. "Seminoma Arising in Cryptorchid Testis 25 Years After Orchiopexy: Case Report." American Journal of Clinical Oncology, 25 (June 2002): 287–288.

Rupp, Timothy J., and Mark Zwanger. "Testicular Torsion." eMedicine, March 25, 2003 [April 4, 2003]. http://www.emedicine.com/EMERG/topic573.htm .

Sessions, A. E., et al. "Testicular Torsion: Direction, Degree, Duration, and Disinformation." Journal of Urology, 169 (February 2003): 663–665.

Shekarriz, B., and M. L. Stoller. "The Use of Fibrin Sealant in Urology." Journal of Urology, 167 (March 2002): 1218–1225.

Tsujihata, M., et al. "Laparoscopic Diagnosis and Treatment of Nonpalpable Testis." International Journal of Urology, 8 (December 2001): 692–696.

ORGANIZATIONS

American Academy of Pediatrics (AAP). 141 Northwest Point Boulevard, Elk Grove Village, IL 60007. (847) 434-4000. http://www.aap.org .

American Board of Urology (ABU). 2216 Ivy Road, Suite 210, Charlottesville, VA 22903. (434) 979-0059. http://www.abu.org .

National Organization for Rare Disorders (NORD). 55 Kenosia Avenue, P. O. Box 1968, Danbury, CT 06813-1968. (203) 744-0100. http://www.rarediseases.org .

Prune Belly Syndrome Network. P. O. Box 2125, Evansville, IN 47728-0125. http://www.prunebelly.org .


Rebecca Frey, PhD

WHO PERFORMS THE PROCEDURE AND WHERE IS IT PERFORMED?


A pediatric surgeon or pediatric urologist is the specialist most likely to perform an orchiopexy in an infant or small child. In an adult patient, the procedure is usually performed by a urologist after referral from the patient's primary physician or the emergency care physician.

An orchiopexy can be performed in the surgical unit of a children's hospital or an ambulatory surgical center. Most orchiopexies in adults are performed as outpatient procedures.

QUESTIONS TO ASK THE DOCTOR


  • How often have you treated a child for cryptorchidism?
  • What are the chances that the treatment will be successful?
  • What should I tell my son about the operation?
  • Are there likely to be any long-term aftereffects?


User Contributions:

freeha
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Dec 26, 2008 @ 11:11 am
Hi,
My son have one side undcended testies and doctor performed opration when he was 5 months old ,,,now i want to know when the size will be same ,
please reply
waiting for your reply
thanks
Z.Angel
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Mar 23, 2009 @ 11:23 pm
Helo, my son have 2 sides undescended testicles. He is now 3 years old. We were planning to have him undergo an Orchiopexy but I am very scared that something might go wrong during surgery.
Could somebody explain to me or assure to me that the surgery well be alright.
thanks
na
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May 17, 2009 @ 7:07 am
Hi
Could you explain me the risk of infertility for a person who had the surgery of 2 sides undescended testicles (the inguinal canal) as an adult?
Ryan
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May 26, 2009 @ 6:18 pm
hi im Ryan im 16 and ive one undesended testicle! What should I do?
William
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Jun 26, 2009 @ 8:20 pm
I had bilateral orchiopexy surgeries to try to correct testicular torsion when I was in my late teens. I had right sided testicular pain (chronic orchialgia) for 10 years after that and ended up having to have a right sided orchiectomy (testicle removed). I still have my left one but I will tell anyone thinking about this surgery to consider the skill of the surgeon very carefully. I was left with nerve damage that required more and drastic surgery to correct.
ali
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Jul 30, 2009 @ 1:13 pm
hi dears
i had 2 side undecended testicles but i have been oporated very late when i was 25 now i am 27 years old, tel now my testicles size small and have azoosperma, could someone tell me the fact and advise me in this regard. i shall be thankfull to him
josie
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Jan 31, 2010 @ 5:17 pm
hi,my son is 8 and a half months,he just had a check up wit the health nurse,in which she found that bout his testicles are undecended,she said they r present,does any body have some info on wat will happen from here,i am scared that he will need an op to correct it,thanks
Dave
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Feb 2, 2010 @ 12:12 pm
I had orchiopexy about 50 years ago, when I was 9 years old (my cryptorchidism had not been discovered until that time). The testes inside the body cavity were too warm for too long, and I have never been to produce sperm.

I write as a fellow patient, not a medical professional, but since no one else is answering questions here, I will give my best approximation, based on my understanding as an educated layman:

1)Freeha - The size may or may not be the same at some point. Ask your boy's doctor about this, and tell any new doctor about the issue so he will be aware of the medical history. My own testicles are obviously different sizes, and when I was in my twenties I was offered a cosmetic implant, which I declined.

2)Z. Angel - You may want a simpler explanation of what the problem is and what they will do about it than this article provides. The surgery is medically necessary. Performed by trained and experienced surgeons, the risks are small. The risks of not doing anything, or waiting too long, are larger - sterility (as I have experienced personally) or testicular cancer.

3)na - My orchiopexy was too late to save my fertility. Once a boy who has had an orchiopexy has begun to produce sperm, they can be examined to evaluate his chances to have children. If your orchiopexy was as an adult, you are probably infertile. You should have a fertility evaluation to settle this.

4) Ryan - You should see a doctor, and probably have the undescended testicle either surgically brought down or removed. Chances are your fertility is not affected, but this can be checked.

5)William - Yes, complications are possible.

6)Ali - Like commenter number 3, you are in a similar position to me. You will not be able to have biological children. Adoption or sperm donation for your wife's pregnancy are options. You may also (like me) be prescribed supplemental male hormones.

7) Josie, depending on the location of the testicles, medication may bring them down, or surgery may be necessary. Have this dealt with promptly.
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Mar 7, 2010 @ 11:23 pm
I had orchiopexy surgery and post op I find my testes are fine but the veins in my penis hurt slightly and having curculation problems in my penis what could the underlying problem.
I started to notice this about three week after surgury.
kelly
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Apr 8, 2010 @ 12:00 am
anyone lost testicle after bilateral orchiopexy ?? if yes, what to do??
mira
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May 20, 2010 @ 4:16 pm
Hello,
My son is 4 years old. He has 2 side undescended testicles. When he was 5 months he had a surgery but it seems that it wasn't sucssesful. I don't know what to do now. I can't see any changes even if we tried to help him when he was baby. His testicles are still in lower part of abdomen because when I try to make him a simple massage I can't find any sign that the surgery could help.
so, please tell me what to do.
I'm from Kosovo and our health services and examination are not meeting even minimum standards.
I really need your help

sincerely
Myrvete Haxholli
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Jun 8, 2010 @ 12:00 am
Dear Doctors

i am 34 years of age and have diagnosed with ultrasound that two of them (testicles) are undescended, right one measures 4.1cm x 2.1cm and left of measures 2.3cm x 1.3cm. i also diagnosed as azoopsermia patient.
with surgery (orchiopexy) both of them can be brought normal and my azoospermia can be treated like this or some hormonal medicines be used.
regards,
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Jun 19, 2010 @ 6:06 am
Dear Doctors,

Aslam o Alaikum,

We have been married since October 2007 and have no kids yet. We gone through some medical test of both and found that I have azoospermia. After that an ultrasound and hormone test is also carried out.
I am 34 years of age and my wife is 36 years of age.
Ultrasound says that I have both testicles undescended, left one is little deep and measures 2.1cm x 1cm and right one is 4.2cm x 2cm.
Hormone report of testosterone is about 219 points and FSH is 46 points.
Kindly let me know what is possible to have kids.

Kindly reply fast, and if possible give me appointment if u are available in Pakistan.

Regards,


Mian Zahid
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Jan 14, 2011 @ 2:02 am
When one has this type of condition, you know bilateral condition for so long is it that dagerous'
Still sometimes the pain comes after sometime a while.
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Feb 5, 2011 @ 4:04 am
Hi Doctors,

I am 31 years of age, and have bilateral undescendent testicles, both of them are indise,
one near the inguinal ring and the other is hiding due to hernia.

I am married with no chidlren, I am in london, uk, Can you suggest me please any good doctor
who can do this operation carefully to bring them down.

Please let me know
Many thanks
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Feb 14, 2011 @ 5:17 pm
I had a torsion surgery in '97 and have had blood in my urine and/or semen EVERY time after a long or "hard" sexy time. and am currently trying to find ANY research to find out why. I would ask your doctor and let me know as well of ANY side effects of this surgery, no long matter after time of the condition.
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Feb 21, 2011 @ 10:10 am
For Myrvete


You should imediately see a urologist, and bring both testes down.There is a higher risk for cancer if you let them up and inside.Usually this is done with a surgery.Don't waste more time.

I wish you luck

Alma
nickie
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Mar 17, 2011 @ 9:09 am
my son has been visiting great ormand street childrens hospital since birth 2004 for kidney/urolgy problems has regular scans and mag3 tests n pelvic examinations,,he had a right pyloplasty operaton in 2006,,to help wiv he kidney,, at a routine check up in may 2010 he was seen by a 'stand-in' consultant who noticed he had 'ectopic testicles' she seemed very surprised that no one had noticed this before considering the amount of check ups, tests and examinations he hd already had n that he had already had an operation before he was 2 yrs old. she said he needed another operation because of the ectopic testicles and ideally this shouldve been done before the age of 2 because of fertility, i mentioned hes previous operation was before he was 2 and she said it shouldve/couldve been done at the same time, he had the operation within a couple of weeks, and all went well,,i am angry, upset and confused as he now has 5 scars in total in that area, the 2nd operation couldve been avoided if theyd noticed before he couldve had it done wiv hes first operation and also he is now 6 and hes fertility will surely now be affected,,plz help,,,angry/worried mum x
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Apr 15, 2011 @ 7:19 pm
hi,my son is 3 and one of his testicle still hasn't descend..what does that mean,would it come down eventually?
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May 20, 2011 @ 10:10 am
i just had a bilateral orchiopexy for a torsion that didnt damage the bloodflow of my testicle,
but currently my right testicle is swollen to about three qaurters the volume of my scrotum,
my doctor told me it may just be an infection, but im just wondering, what its my risk now of losing a testicle later in life? or how could my fertility have been affected? cause after reading a lot of this im starting to get very worried, my doctor never told me that i could be at risk of losing a testicle, and i feel a bit wronged since hearing that there is the possibility i could lose one in the future. please someone who knows, email me directly jzzulu@hotmail.com
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Aug 15, 2011 @ 7:07 am
Hi Doctor
my son going to do orchiopexy SURGERY and his age 8 years i am so scaring about this surgery because the doctor inform me that i am so late this surgery if it done in age 6m-2y it will be safe and may be in 8 years Testicular damage or it will not grow after the surgery
i would like to know a.s.a.p.
1- how i know that testicular damage or not damaged
2- how i know that testicular grow or infected
3- relation between the age for orchiopexy surgery and efficiency of testicular
please help me i lost all my personal peace
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Sep 8, 2011 @ 5:05 am
i appreciate this article. after this operation,how long does it take to recover and return back to normal?
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Oct 12, 2011 @ 12:12 pm
I have a brother at the age of 24,his one testis is at normal place,while the second is coverd little above the scrotum at left side.which is so near to the scortum,seems to have blocked by a layer from coming below to the normal place,He has not married but the quantity of sperm seems normal,what should he do now.After a long wait i have only this way.
bayo
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Jan 15, 2012 @ 11:11 am
Am 27 and I have one of my testis undesended.Am afraid,tell me what I need to do becouse of the future
Thanks
Abhay
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Feb 6, 2012 @ 11:23 pm
Hii
I am Abhay Had orchiopexy in age of 20th and still the testes are brought from superficial ring of kidney to inguinal canal and now my age is 26 and i want to perform another one orchiopexy and ultrasound is normal in vascularity and echotexture of testes.
so please suggest me whether i should go for surgery or not
and what are the complication i can have after surgery..
im waiting for your reply soon.
Antonio
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Feb 20, 2012 @ 12:00 am
Hi I'm 29 and I had a surgery to bring my right testicle down to my scrotum but wasn't successful I had the procedure done in Mexico city when I was 6 now I want to have the procedure done to try to fix it. Is it too late ?? I do have a lil boy and haven't had pain. I do feel my right testicle above my scrotum and by my lower abdomen. Can my testicle be saved and be brought down with another surgery?? Please respond this would help me a lot with my decition on visiting a urologist
johnnd
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Apr 14, 2012 @ 10:22 pm
April 2012
I was 11.6 yrs when I had to have urgent surgery as internal bleeding nearly cost me my life.(1957)
I had been diagnosed with bilateral (both) undescended since age 3.6 yrs. I have welfare doctors medical reports.
My Results: experiences.
1. Do not wait to long to get the operation. The older the maore the mind and emotions hang onto the pain.
n those days kept in hospital for 9 days.
Nowadays in and out. Especially as a child its easy.
2. I have fathered 5 children. # males 2 Females. Now 10 Grandchildren.
3. at age 48 had to get vasectomy as the surgeon in those days did not allow for me being a six foot adult in later life.Therefore did not free-up the growth of the tubes well as it is done nowadays.So for the males the procedure is fine, great. get the child done early in lifre.
For prospective mothers. Don't drink alcohol. Alcohol is the cause of the undescended testicles.
remember the featus is female then changes to male. so huge internal changes HAPPENING AND ALCOHOL AFFECTS THE CHANGING.

FEMALES: You ARE RESPONSIBLE FOR THE PAIN IN BOYS when you drink during the first three months !.

Johnnd
david
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May 19, 2012 @ 7:07 am
Hello, I just turned 30, and I had a undecened testicle since birth, I went thru surgery at age 7 to bring the second testicle down however my parents or myself did pay not much attention and as a result over the years I have noticed hat same testicle has gone back were it was orginally I am a father of 3 kids now. But I wanted to know if all possible I at my age now is too late to have a second sergery to correct problem. Thank you.
sohail
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May 24, 2012 @ 12:12 pm
hello.i m 27 years old.i had a undescened testis since birth.n now i hav right inguinal hernia and right undescened testis.i want 2 go through the surgery.is it risky for me 2 do surgery now.ang can my right testis can work properly after surgery
daniel getachew
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Jun 20, 2012 @ 1:13 pm
it has been very help full reading the article thanks,
michael.a.s.t
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Jul 24, 2012 @ 5:05 am
I am 19 and sexually inactive. I had an on-going dull pain in my right testicle two years ago for 1-2 months but it subsided so i didn't pay a lot of attention. The pain comes back every once in a while and it usually does not last more than a few days. So now the pain has come back about six days ago. The pain is dull but on-going, but started on the fifth day, my right kidney started feeling dull pain as well. I went to see a doctor and I got an Xray of my kidney, a physical check of the testicle, and a urine test and found nothing wrong nor kidney stones. I got referred to a urologist and stayed at a hospital for a night, I got ultrasound and an NCCT, they found nothing wrong, and supposed my pain was caused by a minor intermittent testicular torsion. But i thought I never felt a moment of severe and sharp pain but just general dull pain. they suggested orchiopexy but I declined because I am really scared of operation. i took the time to think about it and while i was convincing myself to get the surgery (doctors said I could heal in a week and be completely normal after a few weeks), I researched for people's responses of it and found almost no positive comment. They all said even in 2 years there isn't a day they don't feel pain, and always feel pulls and tugs inside the scrotum because of the attachment to the testicle. They all said all doctors lied. Now I have no idea what to do and the dull pain still has not subsided. I do want to get this fixed just in case but the outcome and aftermath scares me to death...what should I do?
sam
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Aug 4, 2012 @ 3:03 am
to michael ! I had orchidopexy 2 years ago would advise you not to do it.i feel pulls and after orchidopexy my private life seriously worsend and i got problems . Besides the Cremaster reflex is important and sensitive . Hope i helped you !
Nicole
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Aug 18, 2012 @ 3:15 pm
my son is 4 years old and he had a right orchidopexy done 3 days ago.Now we cant seem to find the left side and the whole right side is very heard from the top of the sack to the bottom. I was thinking that the left side might have moved to the right. is that even possible? How long is the swelling going to last? should it be hard like that?
Nicole
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Aug 18, 2012 @ 6:18 pm
my son is 4 years old and he had a right orchidopexy done 3 days ago.Now we cant seem to find the left side and the whole right side is very heard from the top of the sack to the bottom. I was thinking that the left side might have moved to the right. is that even possible? How long is the swelling going to last? should it be hard like that?
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Nov 6, 2012 @ 8:08 am
MY son just had surgery for testucular torsion. His surgery was completed within about 3 and half hours of the onset of his symptoms. The doctor said there was blood flow to the testicle after the surgery. Is the success rate of saving the testicle fairly high? Can the surgeon usually tell whether he can save the testicle during surgery ?
shintya
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Feb 11, 2013 @ 1:01 am
My son just got orchidopexy surgery on nov 12, he was 3 years at that time. It's been six month now, is it too late. When the size of his left testicle will be the same with the righ one(normal one).
Thx in advance
Paula
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May 11, 2013 @ 11:11 am
My son was was 27 when he had severe pain and was diagnosed with testicular torsion. Surgery was done immediately and the problem solved with permanent stitches inside his testical sack, However he (a year later) still experiences pain where the stitches are and black bruising in the same areas. Is this normal after such a period of time?
dee
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Jun 26, 2013 @ 11:23 pm
my 13 yr old had left testicular pain and swelling. Took him to his pcp 1-2 days later and was diagnosed with epidyimitis, given antibiotic and anti inflammatory med. Pain subsided within a week. 4 months late same thing happened on right side. Again back to the pcp and given same treatment but referred to a urologist whom we could not see for 3 weeks. Urologist sent my son for abdominal and scrotal ultrasound. Results bilateral testicular infarction caused by testicular torsion. Urologist does not recommend surgery because it is not reversible.
Esays absence of any significant vascular flow to either testicle. What are he chances of having children or any type of sexual problems. Any recommendations. Wondering if i had taken him to the er if it would have made a difference.
ndisa
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Jul 11, 2013 @ 10:10 am
My now 15mnth old son had undergone surgery for undescended testecle(orchiopexy) on the left testicle.its been 2months since the surgery but I cannot feel for his testicle still,does dat mean the surgery was unsuccessful? How long after the surgery must I be able to fell his testicle?please help wat do I do now?
somu
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Sep 25, 2013 @ 12:12 pm
i have one undescended testicle and my age is 22 can i bring it down will it function normally again
Ella
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Oct 8, 2013 @ 6:18 pm
I had surgery for bilateral undescended testicles aged 6. Am I infertile? Someone please please answer!!
James
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Oct 12, 2013 @ 2:02 am
I was diagnosed with cryptorchidism at age 8. Both of my testicles were undescended. I had orchiopexy done to correct the problem. The surgery was unsuccessful due to poor operational skills and my left testicle went back up. I had surgery again at age 11. My left testicle was removed because it was atrophic. I now have just the right testicle. I am now 21 years old and have been married for two years with no children yet but my wife and I want a child. I went recently and took a semen analysis and the results read: viscos-normal, volume is 1.5L, spmcount is 0L, RND cell is 9H, motility is greater than 1L, PH semen is 8, only round cells seen, no other cells seen. Can you please tell me my chances of having children or what the problem could be and if it could be fixed? Thank you.

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