Orchidopexie

Orchidopexie, also spelled orchiopexy, is a surgical procedure to relocate and fix an abnormally descended or undescended testis within the scrotum. It is most commonly performed for cryptorchidism in pediatric patients, where one or both testes fail to descend into the scrotum. The operation is typically indicated in infancy or early childhood to improve testicular function and reduce risks of infertility and testicular cancer associated with undescended testes; it may also be considered for retractile testes that persistently remain non-palpable or high-riding.

The operation is usually done under general anesthesia. Approaches include an inguinal incision or a scrotal incision, with laparoscopy used for non-palpable testes. The testis is mobilized by releasing surrounding tissue and, if needed, lengthening the spermatic vessels and vas deferens. The testis is then placed within a surgically created subdartos pouch or fixed to the scrotal wall to prevent re-ascent. The cord structures are carefully preserved, and the incisions are closed.

Outcomes are generally favorable when performed early: restoration of normal testicular position and function, reduced risk of torsion, and decreased cancer risk compared with leaving the testis undescended, though cancer risk remains higher than in peers. Complications can include recurrence or ascent of the testis, testicular atrophy, injury to the vas deferens or blood vessels, infection, hydrocele, or bleeding.

Follow-up typically includes a postoperative visit to assess position and healing, with longer-term monitoring of testicular growth and puberty.