Undescended Testis Surgery for Children

Watch Prof. Dr. Mohamed Elbarbary explain the surgery:

An undescended testicle means that the testicle did not complete its normal journey from the abdomen to the scrotum. It is currently recommended to perform the surgery between the ages of seven and nine months — a timing that has evolved over decades based on long-term follow-up studies; previously, the recommended age was six years. then two years, then one year, until what we consider the standard today. If the testicle remains outside the scrotum, it is more susceptible to changes in its growth and structure, And more susceptible to torsion due to its instability. Delaying does not eliminate the need for surgery, However, it may reduce the window for achieving the best possible outcome

In the paragraphs of this article, we discuss all the details of pediatric undescended testicle surgery, including the appropriate time to perform it and the different techniques pediatric surgeons rely on to bring the testicle down into its place; therefore, if your child is about to undergo this surgery, do not miss this important information.

What is the goal of pediatric undescended testicle surgery?

Pediatric undescended testicle surgery aims to bring the testicle down to its normal place in the scrotum after the child was exposed to certain factors that prevented this from occurring naturally after birth, This is to encourage its normal growth and protect it from the elevated body temperature that damages its cells in the long term

Perhaps many parents wonder about a way to treat an undescended testicle without surgery, as they are haunted by the fear of subjecting their infant, who is only a few months old, to anesthesia and surgical intervention.

Can an undescended testicle in children be treated without surgery?

Unfortunately, an undescended testicle in children can only be treated through surgical intervention, However, the good news is that a large percentage of children recover from it without any medical intervention; as the testicle descends on its own during the first few months of the child’s life, and at that point, only requires periodic follow-up with a pediatric surgeon to monitor its growth and ensure it does not ascend back into the inguinal canal or abdominal cavity.

But when the child reaches a certain age and the testicle has not descended into its place, Then, surgeons are forced to subject the child to undescended testicle surgery.

What is the appropriate time for pediatric undescended testicle surgery? And can it be performed later?

When the child reaches the age of 7–9 months and the undescended testicle has not descended into the scrotum, This is the appropriate time for pediatric undescended testicle surgery, as delaying the procedure exposes the testicle’s cells to several risks that may affect the child’s future reproductive and sexual capabilities.

Our discussion does not mean that undergoing the operation at a later time is pointless, But the expected results of the surgery may decline compared to undergoing it at the appropriate time, The undescended testicle may grow slowly, and its functions may be affected later on.

Therefore, parents must set aside their emotions and anxiety and not delay the decision regarding pediatric undescended testicle surgery, thinking that they are protecting them, For this temporary protection may cause their children to suffer serious complications that will destroy their future later on.

Following up on our discussion regarding undescended testicle surgery, Let us delve into the details of the procedure to reassure parents about how straightforward it is.

Pediatric Undescended Testicle Surgery | Various Techniques Depending on the Type

Pediatric undescended testicle surgery is performed using several techniques depending on the location of the testicle and the physician’s ability to palpate it during the clinical examination of the child, These techniques include the following:

Open Surgery for Pediatric Undescended Testicle also known as Open Pediatric Orchiopexy

Pediatric surgeons resort to this procedure to treat an undescended testicle that can be felt in the inguinal canal—the canal that connects the abdominal cavity to the scrotum.

Under general anesthesia, the surgeon makes a simple surgical incision in the upper thigh area, Then, they carefully bring the undescended testicle down to its place in the scrotum without disturbing the spermatic cord or the blood vessels, And secures it in the scrotum.

Read about: The best doctor to treat undescended testicles in children:

Laparoscopic Surgery for Pediatric Undescended Testicle

In the case of a non-palpable undescended testicle, where doctors suggest it may be located inside the abdominal cavity, using a surgical laparoscope is the ideal solution to bring it down to its place in the scrotum.

Also under general anesthesia, the surgeon creates small surgical punctures in the abdominal area, And inserts the laparoscope tube through them, with its precise camera to explore the location of the undescended testicle, And through the same incisions, they use surgical instruments to bring the testicle down from its location into the scrotum and secure it there.

Whether the pediatric undescended testicle surgery is performed via open surgery or laparoscopy, the procedure does not exceed 60–90 minutes. And the child can leave the hospital on the same day after recovering from anesthesia and ensuring their safety, As for the recovery period from the surgery, we will discuss it in detail below.

Recovery Period for Pediatric Undescended Testicle Surgery

The recovery period for pediatric undescended testicle surgery ranges from one to two weeks, And this duration may vary from one child to another depending on the type of technique used for the surgery, And whether the operation was performed for one testicle or both testicles, And the extent of the parents’ adherence to the instructions recommended by the doctor during the surgery’s recovery period as well, Which usually include the following:

• Ensuring the surgical wounds remain clean and dry, and adhering to the schedule for changing dressings.
• Preventing the child from performing any strenuous physical activities.
• Adhering to the schedule and dosages of medications prescribed by the physician, especially antibiotics, to prevent any infection in the surgical wounds and accelerate their healing.
• Providing the child with light, easily digestible meals to avoid any strain during bowel movements or excessive pressure on the abdominal muscles and the inguinal region.
• Do not be alarmed by the appearance of certain signs at the surgical site; this is considered a normal bodily reaction resulting from the use of surgical instruments in this sensitive area.

Normal Symptoms After Pediatric Undescended Testicle Surgery

The most important symptoms that are not a cause for concern following pediatric undescended testicle surgery include the following:

• Swelling and firmness in the scrotum.
• Redness or bruising in the surgical area.
• Feeling of pain and numbness around the scrotum.

These symptoms take a few days to weeks to disappear completely, But they do not negatively affect the child’s ability to go about their normal life or the healing of the surgical wounds.

After having discussed the pediatric undescended testicle surgery and its various techniques in detail, Let us proceed to answer some of the common questions that parents ask regarding the surgery and its results.

Learn about: Symptoms of undescended testicle

Is the undescended testicle surgery dangerous?

There is no danger to the child’s life from the undescended testicle surgery, provided it is performed by an experienced pediatric surgeon and an anesthesia team specializing in pediatric anesthesia, On the contrary, failing to undergo the procedure or delaying it poses a threat to the child’s future reproductive and sexual health, as well as an increased risk of developing testicular tumors.

Discover here: Is the undescended testicle operation dangerous for children?

Can a person who had an undescended testicle have children?

Of course, an individual who had an undescended testicle can have children if they underwent the surgery in childhood at the age of 7–9 months, However, if they delay undergoing the surgery until puberty or early adulthood, or do not undergo it at all, their chances of fulfilling the dream of having children decrease.

Learn about: What are the risks of an undescended testicle in children?

Can the undescended testicle return after the surgery?

The recurrence of an undescended testicle after surgery is an extremely rare complication, And it is usually a result of the physician’s lack of experience or lack of specialization in paediatric surgeries.

Therefore, parents must ensure the surgeon’s specialization and their level of experience with pediatric undescended testicle surgery to avoid exposing the child to any potential complications after the procedure.

You may ask further questions about pediatric undescended testicle surgery by booking an appointment with Dr. Mohamed El-Barbary—Professor of Pediatric Surgery at Cairo University Faculty of Medicine—via the numbers listed on our website.