Surgery for undescended testicles

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Question

I have just been told that my 11-month-old son has undescended testicles.

The doctor could feel them both but they were higher up in his groin above his penis. He has now been referred to the hospital to see a urologist (I think).

I would like to know what is now likely to happen when he sees the specialist. If he has to have them surgically brought down what does this entail and at what age do they normally carry out this operation.

Answer

Early diagnosis and treatment of the undescended testicle is needed in order to preserve fertility.

Physical examination of the testicle can often be difficult and your doctor is quite correct to refer your son for evaluation by a urologist who can assist with his diagnosis and treatment.

It is possible that your son's testicles are simply retractile, that is they may rise up out of the scrotum when an attempt to examine them is made. If they are truly both undescended, yet within the normal pathway of descent down into the scrotum, surgery is likely to be required to bring them down.

This procedure is usually performed between six months and two years of age and is called an orchidopexy procedure. This can be described as fastening the undescended testicle in its normal position.

Under a general anaesthetic, an incision is made in the scrotum or groin area. The blood supply and nerves to the testicle are identified and carefully preserved.

The surgeon may need to reach into the groin with special instruments to gently bring the testicle down. Under certain circumstances a laparoscope (telescope) may be used.

The testicle, its blood supply and nerves are sewn in place and the skin closed with self-absorbing sutures. Your little man will probably be in hospital for between three and six days.

The success of treatment depends on the position of the testicle(s) at diagnosis.

Yours sincerely

Dr John Pillinger, GP

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