What is an Undescended Testis?

During fetal life, the testes develop high on the backside of the abdomen. They gradually descend through an opening called the inguinal canal into the scrotum. Testicular descent may halt at any point. An undescended testis occurs in 4% of newborn infants, but decreases to about 1% by a year of age. It is more common in premature babies.

An undescended testis will not produce sperm at the normal body temperatures within the abdomen. The testis needs to be brought into the scrotum so it can produce sperm. Also, undescended testes which are not brought into the scrotum have an increased risk of testicular cancer in adulthood. Bringing the testis into the scrotum also makes it easier to detect a testicular tumor later in life.

Most undescended testes can be felt somewhere. If an undescended testis cannot be felt, an intensive surgical exploration must be done to prevent a hidden source of malignancy (cancer of the testes). There are no tests available to definitely prove the absence of the testis.

Surgery:

To repair an undescended testis, an operation called an orchiopexy is performed while the outpatient is under general anesthesia. Since some testes may descend early during the first year, surgery is generally done between 9 months and one year of age.

After the child is asleep, an I.V. will be started by the anesthesiologist to give fluids and medications during the surgery. A horizontal incision is made about an inch over the lowest part of the abdomen. The testis is identified and its blood supply is made long enough to reach the scrotum. Any associated hernia is repaired. The testes is sewn into a surgically-created pouch in the scrotum. The inguinal incision is surgically closed and covered with a steristrip (surgical tape). The scrotal incision is closed with dissolvable stitches that you can see. An antibiotic ointment or other dressing may be applied to the scrotal stitches. Mild swelling or bruising of the scrotum is possible.

Recovery:

After the surgery, the child is taken to the recovery room. Generally, you will be able to be with your child as soon as he is awake. During this time, the effect of the anesthesia gradually wears off. He may be nauseated from the anesthesia. If the child has no problems with nausea or vomiting, a normal diet can slowly be resumed. Please call 602 254-5561 the day after surgery and schedule a follow-up appointment for your child 1 to 2 weeks after the surgery. See the post-operative instructions for more information.