Type of Surgery
Information
Last updated: 02/17/2009
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.
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Other Information
Orchiopexy (or orchidopexy) is a surgery to move an undescended testicle into the scrotum and permanently fix it there. It is performed by a pediatric urologist or surgeon on boys with cryptorchidism, typically before they reach the age of two. Some patients remain undiagnosed until their teenage years and undergo the surgery at that time.
The undescended testicle may be located within the normal line of descent (for example, in the inguinal canal) or high in the scrotum or ectopically (i.e. the abdomen). The surgeon may use an endoscope through the umbilicus to locate the testicle, and through other small opening(s) performs the procedure. The higher the testicle, the less successful the procedure. However, the procedure has a high success rate overall.
Orchiopexy can also be performed to resolve a testicular torsion. If caught early enough and the blood supply can be restored to the testicle, this operation can be performed to prevent further occurrence of torsion. If the blood supply has been interrupted for too long, then an orchiectomy must be performed.
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