# orchiopexy (undescended testicle)



## *Karen* (Jul 28, 2006)

Maybe this should go in health and healing? But since it usually done on toddlers I decided to post this here.

Does anyone have any experience with an orchiopexy? His testicle seems to have moved up (or not moved down even though he grew) in the last 6 months. The urologist wants to do an orchiopexy. This wasn't even the reason we started seeing the urologist in the first place, I almost wish I didn't know so I didn't have to make this decision. I really don't want to put him under general, but I don't want him to be infertile either!


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## eirual (Mar 21, 2006)

I don't know much about this, but I was the careprovider for a boy who went to see a specialist (urologist?) for a pre-op appointment. The Dr. told them things would fix themselves and they didn't end up operating.

In his case, the opening that testicles decend from hasn't closed up yet, so his testes move up and down (I'd say they're mainly up). He was obviously swollen and in pain (hence the referal to a specialist) but as far as I know, the only info we received was to keep the surrounding sac moist with vaseline to prevent cracking and help with discomfort.


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## *Karen* (Jul 28, 2006)

Thanks. It sounds like he had a retractile testicle, not an undescended testicle.


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## Ornery (May 21, 2007)

My youngest son had an undescended testicle. His testicle had never come down and was almost in his abdomen. At around a year, his pediatric urologist indicated that the longer we waited, the more damage could be done. So we decided to go with the surgery. He had it done at 15 months. I was a basket case. We had some bloodwork done a few days beforehand and he did wonderfully with that. Then came the morning of. He was not supposed to have anything to eat prior to surgery except for clear liquids so breastmilk was ok (thank goodness he was still nursing). We went in around 7:00am, waited around, and then I carried him back to the OR. I nursed as they inserted the IV, which he barely even noticed, and held him as they put him to sleep. If I remember correctly, it took about a half hour to an hour. I cried, paced, etc. Then a nurse came and got me and took me back as he was starting to wake up. He woke up in an absolute foul mood. I tried nursing, rocking, singing, everything I could think of but he cried for about the first fifteen minutes. Then he settled down and was his normal happy self. We had to wait a few hours after the surgery as he had to be able to eat, potty, and walk before he could leave. By the time we got home (around 12:30pm), he was trying to run around the house in circles, jump off the couches, etc. It was pretty difficult trying to get him to stay quiet. I gave him tylenol pretty regularly the first few days but he never acted like it hurt at all. The only real limitation he had for the first week was to not have his incisions totally immersed in water. He still has small scars at the two incision sites (lower right hand of abdomen and on his right testicle) but they are fading.

Overall, it was a pretty easy experience. My top recommendation is to find a hospital that will work with you. Some won't allow you to take you ds into the OR or hold him while they are putting him under and that was a MAJOR requirement for me. My ds was extremely attached to me and there was no way I was sending him off with strangers. Also, if at all possible, go with a pediatric urologist not a regular one.

I know it is hard to think of your lo going under for surgery and hope that my description is detailed enough to give you some idea of what to expect.









ETA: My son was born in Feb of 2006.


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## *Karen* (Jul 28, 2006)

Thanks for your story! I hadn't even thought that they wouldn't let me back! Geez. I will have to call and ask about that. We are going for a second opinion, but are already planning on the surgery. I am hoping that it will be harder on me than him!


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## PassionateWriter (Feb 27, 2008)

my son had an undescended testicle and had it repaired surgically when he was 2. the first surgery was actually done during an echo cardiogram he had scheduled (they clipped some blood vessels that were holding the testicle up) and the 2nd surgery was done during an open heart surgery. All of this was done at Children's Hospital in Boston. He was given medication so he was "out" prior to leaving us. He also had issues with anesthesia so couldn't be subjected to regular anesthesia. All in all, the testicle surgeries were uneventful (in the surgical sense) but nerve wracking. We were told that if we didn't have the operation early that he may lose the testicle.


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## HappiLeigh (Mar 30, 2005)

A good friend of mine had a son with this issue. She was not happy about surgery as an option, but finally decided it was probably for the best and consented to surgery when her DS was 22 mos. He ended up having a hernia inside that was preventing the testical from descending. Surgery went well and outcome seems good--that was just 2 weeks ago, but I think they are glad they did it, and glad it's over.


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## aiea (Jan 27, 2007)

My DH had an undescended testicle probably because he was a preemie. His parents did not have it surgically moved until he was into puberty (for no reason I can discern). For years, we assumed that cost him his fertility, and on paper he is indeed infertile (he produces very few sperm but those few are good swimmers). We went 6 years without birth control before our DD showed up, and boy, were we surprised!

That's our story FWIW. I was having quite a time reconciling myself to the fact that my in-laws might've prevented us from having kids. I am glad to know you are researching all the options and looking at the expediency of it. IMVHO - I would say ask all the questions, read as much as you can, and if it all seems right, the sooner the better.


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## *Karen* (Jul 28, 2006)

It is nice to hear the story about your DH. I try to think of that as they want to cut my baby open.

The problem is, is that 6 months ago they thought that it was mostly down and did NOT need surgery because it was spending some time in the scrotum. Now that he has grown, it seems that the testicle has not come down as the body lengthened. Meaning that it just stayed at the same spot making it seem higher. I think that since it is so border line is why I need a second opinion before proceeding. And I think that since it is so border line that it probably hasn't affected his fertility as much as one completely in the abdomen does.

He is 25 months old, and if the second opinion thinks that it needs to be done, the surgery will be June 5th. I know they say 24 months is the magic loss of fertility age, but I try not to buy into that too much and hope that 25 months is fine.


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## goodheartedmama (Feb 1, 2007)

I know how hard this is for you.


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## tbone_kneegrabber (Oct 16, 2007)

My son has an undescended testicle. We have an appointment with a ped urologist on June 5. No one has ever been able to "feel" his other testicle, so my concern is that if there is only one, I don't want them to do surgery "looking" for the other one.


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## sbgrace (Sep 22, 2004)

He sounds really similar to my son. His testicle appeared to be partially descended and the doctor (two doctors, both peds) weren't concerned as it seemed to be ok. Then they realized it was indeed stuck and not coming down. That got more obvious as he aged like it did with your son. So my son had his surgery after 18 months which is a bit late too. I try not to think about that as we can't undo it. But I would have done it earlier if I could have/knew then what I know now.

But beyond the fertility impacts you want it brought down before puberty so he can check for cancer (both testicles are at increased risk for testicular cancer if one is undescended). And at this point if it hasn't come down it isn't going to...and it seems like younger when they won't remember or understand would be a much easier recovery.

Anyway, our experience-I was a complete wreck about the anesthesia especially. They told me it is usually a very fast procedure--just a bit longer than ear tubes that happen in less time than it takes for the child to go under anesthesia. These are usually quick surgeries and it is a common one too. So that is good. My son came out of anesthesia combative and confused/disoriented. I was very scared by that. He didn't seem like himself. This went on a while and then he fell asleep and woke up like his normal self. I later was told this is really typical with kids and anesthesia. So I want to warn other parents of that possibility as it was really scary for me. My son's surgery turned out to be complicated (his testicle was very "stuck" I guess) and more invasive than typical. So he had a lot of bruising and swelling. Still, he was up and running around the next day. No problems or ill effects at all. He has a tiny scar on the bottom part of his scrotum on that side. Nothing that will make him self conscious as an adult and both sides look even.

I know it is scary.


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## PassionateWriter (Feb 27, 2008)

Quote:


Originally Posted by *HappiLeigh* 
A good friend of mine had a son with this issue. She was not happy about surgery as an option, but finally decided it was probably for the best and consented to surgery when her DS was 22 mos. He ended up having a hernia inside that was preventing the testical from descending. Surgery went well and outcome seems good--that was just 2 weeks ago, but I think they are glad they did it, and glad it's over.

i forgot to add that my son also had a hernia.

i always recommend a 2nd opinion prior to any surgery so i think what you are doing is prudent.


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## Sarah W (Feb 9, 2008)

DH had an undescended testicle, also w/ a hernia. They were both repaired when he was 4/5. He has scars, but there were no issues with the surgery. There were no issues with his fertility, either.

One thing I will say...if you son has an undescended testicle, please ensure that he starts doing checks fairly young. Having an undescended testicle makes you 6 times more likely to get testicular cancer. We went through that Oct. 06. DH had just turned 25 when he was diagnosed w/ testicular cancer and had an orchiectomy.


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## aiea (Jan 27, 2007)

Re Sarah W's post, I had also read (years ago) that if the surgery is done by age 5 or so, that gives a good prognosis for fertility. Karen had said that 24 months is the loss of fertility "deadline", but I wonder if that is what you learned from your first dr or if that is the general guideline nowadays?

I would get a second opinion in any case, just to gather more of a consensus, but I wonder if the age "deadline" has changed or if there is more than one opinion on this.

Just trying to buy you time really... I can only imagine how hard this would be as a parent. I had the same thoughts about my husband's parents, but they eventually went through with it. SO glad you are researching this well and planning for your DS's fertility.


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## goodygumdrops (Jan 25, 2007)

Well, this thread has interesting timing. My son was diagnosed with undescending testicle when he was around 3 months. Urologist said he may have hernia and to bring him back when he was 12 months. At his 12 wbv, the pediatrician said he was fine. Well, this past friday I decided to take him in again because was concerned because I can barely ever feel his testicle. Dr said that I was right and referred me to Urologist. I scheduled an appointment for next month.

Well, today my son starting wimpering and holding his groin so I looking and he had a huge bulge that was sensitive to touch. My dh and I took him to er and they said that it was probably a hernia but could be inflamed testicle, twisted testicle, or something else so he sent us to Children's. Mind you, he was SCREAMING in pain. It was awful.

So, we get to Children's and the dr does some other tests and decides its a hernia. She then manages to push it back in and it was like night and day...my son stopped fussing immediately. SO, he is going to have surgery in the next week. Unfortunately, the couldn't do in tonight so they sent us home with prescription for pain killers and told us to really watch him. I know, crazy huh!! I cannot believed that this could happen again.

So, we're calling first thing Tuesday morning and begging them to do the surgery asap. I really hate the idea of it happening again


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## sbgrace (Sep 22, 2004)

Quote:


Originally Posted by *aiea* 
Re Sarah W's post, I had also read (years ago) that if the surgery is done by age 5 or so, that gives a good prognosis for fertility. Karen had said that 24 months is the loss of fertility "deadline", but I wonder if that is what you learned from your first dr or if that is the general guideline nowadays?

.

Our surgeon told us that they used to say you had more time but now they know that cellular changes start happening even as young as one and he was upset we didn't get there until my son was so much older. I'm sure more happen as time goes on though. Here's some study information:

Quote:

Through testicular biopsy at the time of orchiopexy, germ cell density has been shown to decrease over time, beginning as early as one year of age.7,8 For this reason, treatment of the undescended testicle is recommended as early as six months of age and should be completed before age two.
http://www.aafp.org/afp/20001101/2037.html
Not that this is encouraging...and honestly I'm not too worried. Most people with one testicle are going to be able to have kids unless there is something else going on. Even then with technology now in fertility most can have kids with almost no sperm.


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## sbgrace (Sep 22, 2004)

Quote:


Originally Posted by *Gavin'smom* 
Mind you, he was SCREAMING in pain. It was awful.

So, we're calling first thing Tuesday morning and begging them to do the surgery asap. I really hate the idea of it happening again

















How horrible. I hope he has no more issues until the surgery.


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## Sarah W (Feb 9, 2008)

Quote:


Originally Posted by *aiea* 
Re Sarah W's post, I had also read (years ago) that if the surgery is done by age 5 or so, that gives a good prognosis for fertility. Karen had said that 24 months is the loss of fertility "deadline", but I wonder if that is what you learned from your first dr or if that is the general guideline nowadays?

Oops, let me be more accurate. His sperm count was perfectly normal and we got pg our first try. However, that was after he'd had that testicle removed because of cancer. I can't testify to the fertility of that particular testicle because it was gone by the time we started thinking about children.


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## Ornery (May 21, 2007)

We were told by our ped urologist to get it done ASAP (meaning btwn 12 mos and 18 mos) so as to not run the risk of any fertility problems. Also told that by the ped. urologist at the large university hospital nearby. They didn't give us a fertility "deadline" but it made sense to me to get it done sooner rather than later.

Of course, our son's testicle was secured in his abdomen and there was absolutely no way that it would descend on its own (we knew there was little likelihood of it from his birth, when they did an ultrasound to check its position and to make sure there was no obvious hernia).


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## *Karen* (Jul 28, 2006)

We are going tomorrow for the second opinion.

Has anyone heard of the hormone therapy? I'm not big on having testosterone injected there, but I'm not big on general anesthesia either. From what I've read it usually isn't effective, but since it is so close I was hoping that it would make a difference.


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## Alki Mama (Jul 9, 2007)

Quote:


Originally Posted by *Eclipse95* 
Then came the morning of. He was not supposed to have anything to eat prior to surgery except for clear liquids so breastmilk was ok (thank goodness he was still nursing). We went in around 7:00am, waited around, and then I carried him back to the OR. I nursed as they inserted the IV...

Our DS is also slated to have this surgery, and I'm quaking just thinking about it. But I wish we had your hospital -- it's great that you got to go in with him! Our hospital (Children's in Seattle) told us clear liquids meant NO breastmilk, because that's considered a food. That was very upsetting for me to hear, and I'm worried how to explain that to a 1-year-old! They want to schedule the surgery for first thing in the morning, but I'm wondering if later in the day would actually be easier, when he's more distractable. Clear liquids, they said, are only water and juice, and then he can have nothing AT ALL for some amount of time before the surgery -- they're supposed to let me know the specific amount of time when they call the day before. DS really doesn't drink out of a cup yet and doesn't take a bottle, and anyway I don't think nursing is so much about food for him as it is comfort, so how to deny that? Argh. And just the thought of putting my baby under the knife... I hate this stupid surgery!

Anyone else have experience with keeping your LO from nursing for several hours without major screaming? Anyone have encouragement on ignoring the hospital recommendations?









The main reasons we're intending to go through with it are to possibly increase future fertility (even though he has one normal testicle so could probably get by just fine) and to enable checking for testicular cancer more easily. If not for the first point, I'd wait longer until DS was old enough to understand what he was going through with the surgery (and the anesthesia seems safer with an older child), which is maybe why some parents used to wait until grade school or puberty age. But I know a few stories of that ending in infertility, so I do want to respect my DS's future reproductive options. I'd hate for him or his future spouse to look back at me as the person who kept them from having their own babies just because I was too squeamish to endure a day or two of unpleasantness. But it's hard when he's so little to imagine him into the future like that! All I have is him now, when I so don't want to bring him to an operating room.

Did any of you feel the need to ensure that your DS remained uncircumcised and unmessed with during the operation? I'm a little paranoid that they'll do something hinky with his foreskin like retract it, but I'm feeling sheepish about bringing it up, as if I'm accusing them irrationally in advance. How do you bring this up tactfully but firmly enough that everyone on the surgical team gets the message?


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## Alki Mama (Jul 9, 2007)

Quote:


Originally Posted by **Karen** 
Has anyone heard of the hormone therapy? I'm not big on having testosterone injected there, but I'm not big on general anesthesia either. From what I've read it usually isn't effective, but since it is so close I was hoping that it would make a difference.

I've heard of the hormone therapy, though our consulting urologist never even mentioned it. But, like you said, your son's testicle sounds more retractile or at least just at the cusp of descending, so it might be more effective. Let us know what you find out from the second opinion if you brought it up. Is it possible, though, that the testicle is hung up on something that's keeping it from descending? In that case, I suppose hormones wouldn't help it lengthen out. I wish there were more time to wait and see, but there's that ticking fertility clock -- sigh.

They couldn't feel our DS's undescended testicle at all, so ours is as much an exploratory surgery as it is to bring it down if/once they find it. I think it's a good sign that they at least know where your son's is, so maybe there are more options, or at least it would be a faster surgery. GL!

Just a small rant about the ped urologist we saw -- we drove an hour and waited another two for a 5-minute visit during which she confirmed what two other doctors and our common sense/research had already told us: yup, no testicle, needs surgery. She doesn't even schedule the surgery for us -- we have to call someone else to handle that, and that person was too busy to talk to us while we were there. Just got a bill for the visit: $300.







: The good news is I found out we qualify for the poor-people discount at the hospital. (It's really called the Financial Assistance Program or some such, but I prefer poor-people discount.







) So that will help us afford this surgery. I can't imagine how much it's going to cost, and no one at the hospital will give me an estimate! Do any of you know who already had it? We have to pay for our own insurance and have a $6,000 deductible. I was really trying to get this stupid thing scheduled for last year when we had better coverage, but hospital bureaucracy moves sloooowly.


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## *Karen* (Jul 28, 2006)

Our second opinion today was very interesting.

He said that *paternity* is NOT statistically lower with one testicle. Sperm count was, but not actual paternity. He said that he would still recommend having it done, but that even if I didn't he should still be able to have children. He also said that that testicle even if moved down probably won't ever be fertile anyway. I DO think that it needs to come down to check for testicular cancer, but I don't think I am in a hurry in any way.

It was nice to have a different view on things. He seemed very educated on the topic and talked to me with both sides in mind. I may just drive up there to have the surgery done at some point, but I'd hate to have my baby strapped in a 5 pt harness car seat for an hour and a half right after they cut into his package.


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## Alki Mama (Jul 9, 2007)

Quote:


Originally Posted by **Karen** 
Our second opinion today was very interesting.

He said that *paternity* is NOT statistically lower with one testicle. [...] I DO think that it needs to come down to check for testicular cancer, but I don't think I am in a hurry in any way.

It was nice to have a different view on things.

Thank you so much for sharing your second opinion for free!









This is exactly what I've been thinking -- one testicle has PLENTY of sperm to make a baby, assuming that the descended testicle is fine. I do have some worries that an accident or illness might harm DS's normal testicle, but such an event could end up harming both testicles together, and is a slim chance regardless. There's also a weird chance I've read about where the undescended testicle could twist around and cut off blood supply somehow to the descended one and harm it (??), but again I would think that would be a rare occurrence. There's also the possibility in our case, since no one has been able to feel the testicle anywhere, that the second one never even developed, which would mean that it should probably still be removed but that time would not be of the essence -- unfortunately, there's no way to know without the surgery.

What do you think you're going to do? How long would you wait to do the surgery?

The ped urologist we talked to was very cut-and-dry and didn't offer any other opinions or even suggest there were options. I knew from my own research and consideration that that was a limited view, but it's nice to hear that an expert said so! The urologist we saw, for instance, said that without the surgery, DS's risk of cancer would go up -- whereas from my research, I understand that his risk of cancer has gone up anyway due to the abnormal development, and that foregoing the surgery would just increase the risk of not detecting the cancer early. That's not an insignificant risk, which is why it's probably good to do the surgery at some point, but when is ideal in that case? Older childhood?

Quote:


Originally Posted by **Karen** 
I'd hate to have my baby strapped in a 5 pt harness car seat for an hour and a half right after they cut into his package.

I never thought about that! Ouch. Of course, DS's favorite thing right now (and probably for all time...) is playing with his package, and he is not at all gentle. lol

Our regular ped has a personal experience in that her DH's mother chose not to do the surgery for his TWO undescended testicles until school age, so he was indeed infertile. (Of course, there's no telling he wouldn't have been anyway.) But, then, they've adopted a daughter and are very happy. But it makes it a little awkward for me to tell our ped we wouldn't be doing the surgery young. I think I might need to go with a second opinion as well, just to have something to bring to her because I wouldn't want to hurt her feelings on such a sensitive subject.

Another $300...sigh.


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## *Karen* (Jul 28, 2006)

Quote:


Originally Posted by *Alki Mama* 
What do you think you're going to do? How long would you wait to do the surgery?

I'm really not sure yet. We have an appointment for next Thursday and I haven't decided what to do. It is with the first doctor that I really don't like. I'd rather see the second one since he even said he would take a less invasive approach since it is so low (he will just make an incision in the scrotum and not in his abdomen.) I am going to call the first doctor and try to speak with him about it.

Quote:


Originally Posted by *Alki Mama* 
The urologist we saw, for instance, said that without the surgery, DS's risk of cancer would go up -- whereas from my research, I understand that his risk of cancer has gone up anyway due to the abnormal development, and that foregoing the surgery would just increase the risk of not detecting the cancer early. That's not an insignificant risk, which is why it's probably good to do the surgery at some point, but when is ideal in that case? Older childhood?

The one I saw yesterday mentioned this to me. Then I stated that I had read that the increase in risk was regardless. He said that there is information both ways. No matter what it is a real threat that he needs to know his whole life to stay on top of. I don't really know an ideal time, hence my indecision!


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## *Karen* (Jul 28, 2006)

I did forget to post one thing about my conversation with the doctor. He told me that IF DS was between six and twelve months of age that he would recommend getting the surgery ASAP as it may still have some fertility potential, but that DS is too old to have much.

Alki Mama, I noticed that your DS is a lot younger than mine, you make want to keep that in mind.


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## Alki Mama (Jul 9, 2007)

Thanks for the extra info!! That's really helpful. It would be great if your DS could at least have the less invasive surgery -- here's hoping that works out for you.

Quote:


Originally Posted by **Karen** 
He told me that IF DS was between six and twelve months of age that he would recommend getting the surgery ASAP as it may still have some fertility potential, but that DS is too old to have much.

Alki Mama, I noticed that your DS is a lot younger than mine, you make want to keep that in mind.

I had heard that the new cutoff for some doctors was getting closer to 6 months because of the fertility issue, which is why I'd been trying to get DS in from when he was 4 months old -- 7 months later, I got my first appointment! The wheels turn slowly... Now DS will be 14 months at the earliest that he has the surgery, so I'm not sure how good that testicle's chances are fertility-wise. But, certainly, if there is a chance, the sooner the better.

Philosophically I've been thinking this whole thing over. The urologist told me they do ~5 of these surgeries a _week_ at the one hospital. In some sense, of course, that's very reassuring that it's a safe and common procedure. But then I wonder if it's that common a "defect" why it needs to be fixed at all. The thing I come back to is the risk of cancer, which I'll assume didn't used to be as big a risk as other diseases in an evolutionary sense. But I can't imagine that such a common problem would lead to widespread infertility, when the whole goal of any species is to reproduce, and humans have been managing just fine in that regard. Anyway, the increased risk of cancer is still there, so I agree something needs to be done in this day and age when we can. I just wonder if someday people will look back at orchiopexy and think, "Remember when they used to cut into 5 babies a week? How heavy-handed and barbaric." But that will be when there's some fabulous new way to detect testicular cancer early. Maybe orchiopexy will be the new tonsillectomy, which they used to do willy-nilly for sore throats before realizing that maybe cutting off body parts wasn't the best idea in all cases.

Anyway, I don't see a better option right now, but I'm having trouble finding a surgeon who'll discuss the matter reasonably with me and not just knee-jerkingly recommend...hey, immediate surgery, whaddayaknow. I'm glad you were able to find someone who'd talk with you a little more in-depth. Thanks for sharing what you found out, and best wishes in making your decisions.


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## Alki Mama (Jul 9, 2007)

Quote:


Originally Posted by **Karen** 
The one I saw yesterday mentioned this to me. Then I stated that I had read that the increase in risk was regardless. He said that there is information both ways. No matter what it is a real threat that he needs to know his whole life to stay on top of. I don't really know an ideal time, hence my indecision!

You're right. Here's a link I came across from a 2007 review of studies suggesting that doing the surgery before age 10 would decrease the cancer risk.
http://www.urotoday.com/58/browse_ca..._abstract.html

I keep wondering about the psychological aspect for the surgical patient as well -- is it easier to deal with and recover, the younger the baby? I would imagine so. A grade schooler who understands what's going on would be old enough to fear what's going on. A baby might be very fearful in the moment but then quickly forget.

Despite all my hesitancy, I'm leaning toward just scheduling and getting it over with this summer.


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## *Karen* (Jul 28, 2006)

Quote:


Originally Posted by *Alki Mama* 
Despite all my hesitancy, I'm leaning toward just scheduling and getting it over with this summer.

Yep, me too.


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## Alki Mama (Jul 9, 2007)

Just as an update on our DS: There was an opening earlier in the summer, and we had approximately zero minutes to decide whether to take it, so we went with it.

It was at Children's Hospital in Seattle, and I have to give them props. Everyone was very kind to us and DS, and very gentle with him, and the doctors explained everything to us without condescension. The whole team introduced themselves before the surgery and told us their roles. Also, no one touched his foreskin -- hooray! During surgery, I was directed to a dedicated pumping room I could use to help with how swollen with milk I was. And when DS came out of surgery, they left us alone in a darkened room to breastfeed for hours while DS napped and fully awakened from the anesthesia. Seriously, they didn't bother us once -- very nice.

The one thing I really didn't appreciate was the overly restrictive guidelines regarding fasting from breastmilk before surgery -- 8 hours. Since that's way over the recommended time from the Am. Society of Anesth., I went ahead and followed the ASA's guidelines instead, not that I'm recommending that for anyone else. I'm planning to write the hospital a thank-you letter that includes a request to change their bm guidelines on npo.
references: http://www.kellymom.com/health/illne...y-surgery.html
http://www.asahq.org/Newsletters/200...atric0200.html

The surgeon made two small incisions, one in the bellybutton and one in the scrotum. They're barely noticeable, particularly the bellybutton one. DS had no second testicle -- the surgeon said that the blood supply had been cut off to it at some point (he theorized that it was during birth), and so it never developed past a little smear of tissue, which he scraped out of the scrotum to send off for biopsy. We haven't heard back on that, so I'm assuming no news is good news, as expected.

So I have mixed feelings about it. In some ways, the surgery went a little easier than I'd feared, and I was pleasantly surprised by the hospital experience. But it seems a little pointless in retrospect -- there was no testicle to save, so DS could have put off the surgery, perhaps indefinitely, but of course we didn't know that. Could an ultrasound have told us that? I don't know. Was it better to do it now than later? Maybe. Would it have been better not to have done it at all and lived with not knowing? Probably not. But the fact is, he _didn't_ have an undescended testicle -- he had a descended one that stopped developing. I don't know what the risk factors of cancer are for that vs. undescended, but I imagine they're smaller. This one theoretically wasn't (genetically) abnormal until some accident robbed it of blood supply. And he should still be fertile with the existing testicle.

The recovery was quick although somewhat intense, mostly due to trying to get DS to take pain medication. He's not big on solids or swallowing liquids other than bm from the breast, and the pharmacy couldn't understand our desire for a suppository vs. liquid meds. We eventually mixed the overly sweetened meds into sherbet (very healthy, I know), and when he was in a better mood, pureed prunes and applesauce. It was seriously like pilling a cat otherwise. Screaming, thrashing head, red dye everywhere.

After a couple days, we stopped bothering with the pain meds during the day and used them only at night a few more times if he seemed to be having trouble sleeping through the pain. He was scootching around the day of the surgery. The incision sites healed quickly with minimal oozing and crusting, and the stitches dissolved on their own. We put the prescribed antibiotic ointment on for the first couple weeks or so a few times a day.

We go back for a post-op check next week, so I can let you know if we learn anything different there. But I just thought I'd post in case other people were curious about the procedure. Hope your situation goes/has gone smoothly, *Karen*!


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## *Karen* (Jul 28, 2006)

Aw, thanks for the update. Bummer that there wasn't one there! But there was no way to know that!

We have it scheduled for September. We went with the second opinion guy because we just really didn't like the first guy. I am trying to just not think about it too much right now!


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## juliamiron (Jul 29, 2013)

Just got back from the surgery center with our 15 month old. He just had an orchiopexy and is now sleeping upstairs in his crib He seems to be doing well... he had no reaction to the anesthesia which was of course our biggest concern. He has two incisions... one on the lower abdomen (2 inches) and one on the side of his scrotum (1inch). They located the testicle... the canal was closed so they just opened the canal and brought it down. The testicle is perfectly healthy. We debated doing it as well but I think what pushed us to do it was that the chance of cancer later in life is higher if you leave it. Of course he may still get cancer, but this way we know we did everything we could to give him the best chance of fertility and hopefully a cancer free life. Feel free to check back with me if you have any questions Hope this helps and best wishes to you!


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## sarahsarahw (Mar 1, 2014)

Quote:


> Originally Posted by *Alki Mama*
> I keep wondering about the psychological aspect for the surgical patient as well -- is it easier to deal with and recover, the younger the baby? I would imagine so. A grade schooler who understands what's going on would be old enough to fear what's going on. A baby might be very fearful in the moment but then quickly forget.


Late to the thread but that's what I'm leaning towards if our DS needs it. My dh had the op done when he was about 3 and the memories of it still affect him a bit. I think the earlier you can have it done the better. I've badgered dh to write it up and hopefully get it out of his system, so if you want it from a little boy's perspective he's posted his story online.


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## Janesch (Jul 23, 2014)

*Undescended testicle*



juliamiron said:


> Just got back from the surgery center with our 15 month old. He just had an orchiopexy and is now sleeping upstairs in his crib He seems to be doing well... he had no reaction to the anesthesia which was of course our biggest concern. He has two incisions... one on the lower abdomen (2 inches) and one on the side of his scrotum (1inch). They located the testicle... the canal was closed so they just opened the canal and brought it down. The testicle is perfectly healthy. We debated doing it as well but I think what pushed us to do it was that the chance of cancer later in life is higher if you leave it. Of course he may still get cancer, but this way we know we did everything we could to give him the best chance of fertility and hopefully a cancer free life. Feel free to check back with me if you have any questions Hope this helps and best wishes to you!


My baby had a surgery too just like your son, but I'm concern that I don't see his testicles yet on the proper location after 4 months of surgery. Is your baby's testicles on the right place now after the surgery?


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## Bub (Mar 1, 2019)

Alki Mama said:


> Quote:
> 
> 
> 
> ...


Im 17 and had the surgery today. Unfortunately they had to remove my right testicle but they did tell me my left was good. I'll be honest with you, pain is very minimal the worst part is the fact that you know you have been cut open in that area. If you have any questions please feel free to ask


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## Bub (Mar 1, 2019)

Alki Mama said:


> Thanks for the extra info!! That's really helpful. It would be great if your DS could at least have the less invasive surgery -- here's hoping that works out for you.
> 
> Quote:
> 
> ...


If you would like, I had the surgery today I can probably answer some of your questions. I like to help others so if there's any questions or you would like to know more about my experience you can get ask on here or privately message me on Instagram my insta is @_baby_shark_doo I'm usually up late and get up early so if there's any time you need to ask questions about my experience with orchiopexy surgery feel free to message me


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## Fabianne (Mar 8, 2021)

*Karen* said:


> We are going tomorrow for the second opinion.
> 
> Has anyone heard of the hormone therapy? I'm not big on having testosterone injected there, but I'm not big on general anesthesia either. From what I've read it usually isn't effective, but since it is so close I was hoping that it would make a difference.


 Hi ?? I'm new here and it's 2021, I know this happened to you a long time ago, but I'm curious how did it go? My son is 25 mo and has his left testicle undescended... Any tips would be welcomed!


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## Fabianne (Mar 8, 2021)

juliamiron said:


> Just got back from the surgery center with our 15 month old. He just had an orchiopexy and is now sleeping upstairs in his crib He seems to be doing well... he had no reaction to the anesthesia which was of course our biggest concern. He has two incisions... one on the lower abdomen (2 inches) and one on the side of his scrotum (1inch). They located the testicle... the canal was closed so they just opened the canal and brought it down. The testicle is perfectly healthy. We debated doing it as well but I think what pushed us to do it was that the chance of cancer later in life is higher if you leave it. Of course he may still get cancer, but this way we know we did everything we could to give him the best chance of fertility and hopefully a cancer free life. Feel free to check back with me if you have any questions Hope this helps and best wishes to you!


Yay ? I'm so happy for you! I've been going through the same with DS, he's 25 mo and has to get surgery for undescended testicle (only his left side is undescended). The testicle is visible in the upper region of the scrotum, so maybe it'll be an easier surgery? I'm just a nervous mess and i fear so much for my boy ? i don't want them to cut him open....


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