Orchidopexy

Orchiopexy, also called orchiopexy, is a surgical procedure to move an undescended testis into the scrotum and secure it there. It is most commonly performed to treat cryptorchidism in boys, with the aim of reducing risks to fertility and lowering the chance of testicular cancer later in life, as well as to repair any accompanying inguinal hernia if present.

Timing and evaluation of the condition vary, but many guidelines favor performing the procedure in infancy or early childhood, typically around 6 to 18 months of age, to optimize reproductive outcomes. If a testis cannot be felt in the scrotum, evaluation may include physical examination and, in some cases, diagnostic laparoscopy to locate a nonpalpable testis. Imaging studies are not routinely required. Preoperative planning also assesses for concurrent inguinal hernia or other anomalies.

The operation is usually performed through an inguinal incision or a scrotal approach. The surgeon mobilizes the testis and its blood vessels, moves the testis into a newly created pouch in the scrotum, and secures it to prevent re-ascent. In some cases, particularly when the testis is high in the abdomen, a two-stage Fowler-Stephens procedure may be used. Microsurgical techniques may improve precision in delicate dissection.

Postoperative care includes standard anesthesia recovery and activity restrictions as advised by the surgeon. Outcome is generally favorable for palpable testes, with high rates of successful placement in the scrotum. Complications can include recurrence or ascent of the testis, testicular atrophy, infection, hydrocele, or hernia formation. Long-term monitoring is recommended to assess growth, function, and any late effects on fertility or cancer risk.