What are the other Names for the Procedure?
- Cryptorchidism Repair
- Repair of Undescended Testicle
- Testicular Torsion Repair
What is Testicle Fixation (Orchiopexy) surgical procedure?
Testicle Fixation procedure is a surgery where the undescended testicle, or a twisted testicle is fastened to its normal position.
What part of the Body does the Procedure involve?
A Testicle Fixation procedure involves the testicle, vas deferens, the scrotum, nerves and blood vessels in the scrotum.
Why is the Testicle Fixation (Orchiopexy) surgical procedure Performed?
- Undescended testicle (cryptorchidism), which is observed in infants, could occur due to a number of reasons
- In most cases, the condition usually resolves itself in 3-6 months after the delivery
- If not an Orichopexy (also known as Repair of Undescended Testicle, or Testicle Fixation) might be needed
- The physician first confirms the position of the testicle; whether it is undescended or atrophied, due to lack of blood supply during birth
- The testicle torsion is a condition where in the spermatic cord is twisted around the testicle
- This is observed in males below the age of 30, usually between the ages 12-14
- The Testicle Fixation procedure is performed to cure the conditions described above and to lower the risk of a traumatic injury to the region. These conditions (i.e. cryptorchidism and twisted testicles) increase the risk of infertility and testicle cancer.
What are some Alternative Choices for the Procedure?
There is no other effective alternative choice to reposition the testicle.
What are the Recent Advances in the Procedure?
Various developments are being carried out to make the procedure as less invasive as possible with precision and quick recovery. Laparoscopic methods are also used to carry out this procedure.
What is the Cost of performing the Testicle Fixation (Orchiopexy) surgical procedure?
The cost of Testicle Fixation (Orchiopexy) surgical depends on a variety of factors, such as the type of your health insurance, annual deductibles, co-pay requirements, out-of-network and in-network of your healthcare providers and healthcare facilities.
In many cases, an estimate may be provided before the procedure. The final amount depends upon the findings during the surgery/procedure and post-operative care that is necessary.
When do you need a Second Opinion, prior to the Procedure?
- It is normal for a patient to feel uncomfortable and confused with a sudden inflow of information regarding procedure and what needs to be done
- If the patient needs further reassurance or a second opinion, a physician will almost always assist in recommending another physician
- Also, if the procedure involves multiple surgeries or has many alternatives, the patient may take a second opinion to understand and choose the best one. They can also choose to approach another physician independently
What are some Helpful Resources?
http://www.nlm.nih.gov/medlineplus/ency/article/003002.htm (Accessed on 09/03/2012)
http://www.surgeryencyclopedia.com/La-Pa/Orchiopexy.html#b (Accessed on 09/03/2012)
Prior to Testicle Fixation (Orchiopexy) surgical procedure:
How is the Testicle Fixation (Orchiopexy) surgical procedure Performed?
- Once anesthesia is administered; a small incision (cut) is made in the scrotum or groin area
- If the testicle is located further up, the incision may be extended to the lower abdomen. The nerves and blood vessels are carefully preserved
- If the testicle has not descended from the abdomen, the surgeon reaches the inguinal canal with special instruments and gently pulls it down
- The testicle, its blood supply and nerves, are pulled to the bottom of the scrotum and sewn in place
- The skin is then closed with sutures that can be absorbed by the body
- For testicle torsion, the spermatic cord twisted around the testicle is slowly untangled and kept in place
Where is the Procedure Performed?
The procedure is performed in the surgical facility of a hospital.
Who Performs the Procedure?
A general surgeon or an urologist performs the Testicle Fixation surgery.
How long will the Procedure take?
It takes about an hour to perform the procedure.
What do you need to tell your Physician before the Procedure?
It is very important to provide the following information to your healthcare provider. This enables your healthcare provider in assessing the risks for the surgical procedure and helps avoid unnecessary complications.
- Provide a complete list of medications you are currently, taking to your physician. This information is useful for a variety of reasons. For example, it can help your healthcare provider prevent complications due to a drug interaction
- If you are allergic to any specific medication or food items
- If you are taking blood thinners, such as aspirin, warfarin, herbal supplements, or any other such medications
- If you or your family members, have a history of bleeding disorders, or if there is a tendency to bleed more than normal
- If you have diabetes, high blood pressure, chest pains, or have previously suffered from a heart attack
- If you have ever been diagnosed with blood clots in your leg (deep vein thrombosis) or lung (embolism of lung)
- If you have a history of frequent bone fractures (this may affect bone-healing, if bones are involved as part of your procedure)
- A list of all previous surgical procedures you have undergone, like for example: Removal of appendix, gallbladder, or any other part, of your body; surgical repair of any body part, such as hernia repair, perforation of bowel wall, etc.
What Preparations are needed, prior to the Procedure?
- The physician may evaluate the patient’s medical history to gain a comprehensive knowledge of the medications that are being taken currently
- Some of the medications may increase the patient’s chances of bleeding and hence the physician may recommend them to stop such medications for a period of time before performing the procedure
- Sometimes blood test might be performed to determine if the patient has a bleeding tendency or any other medical conditions that prevent them from undergoing the procedure
- The patient must avoid eating or drinking at least 8 hours prior to the surgical procedure, depending on when the procedure is arranged
- For persons suffering from diabetes, it is important that the blood sugar stays within the normal range; if not their diabetologist may have to control blood sugar by recommending insulin and/or a combination of oral medicines
- A physician will request your consent for Testicle Fixation surgery procedure using an Informed Consent Form.
What is the Consent Process before the Procedure?
A physician will request your consent for the Testicle Fixation procedure using an Informed Consent Form.
Consent for the Procedure: A “consent” is your approval to undergo a procedure. A consent form is signed after the risks and benefits of the procedure, and alternative treatment options, are discussed. This process is called informed consent.
You must sign the forms only after you are totally satisfied by the answers to your questions. In case of minors and individuals unable to personally give their consent, the individual’s legal guardian or next of kin, shall give their consent for the procedure.
What Tests are needed, before the Testicle Fixation (Orchiopexy) surgical procedure?
The physician requires the following tests before the Testicle Fixation procedure is performed:
- An ultrasound
- Routine blood tests
- Routine urine examination
- The physician may suggest further tests depending on the health of the patient and their medical history.
What are some Questions for your Physician?
Some of the basic questions that you might ask your physician are as follows:
- What is a Testicle Fixation procedure?
- Why is this procedure necessary? How will this procedure help?
- What does the procedure involve?
- Will I need adjunct treatments after the surgery?
- How soon should I get it done? Is there an emergency?
- Who are the medical personnel involved in this procedure?
- Where is the procedure performed?
- What are the complications associated with the surgery?
- What are the risks involved?
- How long will it take to recover? When can I resume normal work?
- Are there any lifestyle restrictions or modifications required, after the procedure is performed?
- Are there any follow-up tests, periodic visits to the healthcare facility required, after the procedure?
- Is there any medication that needs to be taken for life, after the procedure?
- How many procedures have you performed?
- What are the costs involved?
During the Testicle Fixation (Orchiopexy) surgical procedure:
What kind of Anesthesia is given, during the Procedure?
During the procedure, a spinal anesthesia or a general anesthesia is injected. A general anesthesia is preferred for children.
How much Blood will you lose, during the Procedure?
The blood loss during a Testicle Fixation procedure is minimal. No transfusion is required unless any complications arise.
What are the possible Risks and Complications during Testicle Fixation (Orchiopexy) surgical procedure?
The possible risks or complications that may arise during the surgery are:
- Reactions to the anesthesia
- Excessive bleeding
- Injury to other parts
- Damage to the testicle blood supply causing a decreased blood flow to the testis, eventually resulting in testicular necrosis
What Post-Operative Care is needed at the Healthcare Facility after Testicle Fixation (Orchiopexy) surgical procedure?
At the healthcare facility, generally there is no requirement for any post-procedure care, unless any complications arise.
After the Testicle Fixation (Orchiopexy) surgical procedure:
What are the possible Risks and Complications after Testicle Fixation (Orchiopexy) surgical procedure?
The following are the possible risks and complications after a Testicle Fixation surgery:
- Testicle torsion (in case of undescended testicle surgery)
- Surgical wound infection
- Atrophy of the testicle
- Blood clots or bleeding in the scrotum
- Re-ascend of the testicle (extremely rare)
What is the Prognosis after the Surgery?
The outcome of this procedure is usually good; the testicle is moved into place without complications. However, the rate of success depends on the position of the testicle before descending.
When do you need to call your Physician?
Do contact your physician if you notice any of the following symptoms:
- Increase in swelling, pain, redness, drainage, or bleeding in the surgical areas
- Discomfort or difficulty while urinating
- Nausea or vomiting
- Fever or dizziness
What Post-Operative Care is needed at Home after Testicle Fixation (Orchiopexy) surgical procedure?
At home, the following post-operative care is recommended, after Testicle Fixation procedure:
- Follow dressing instructions given by the physician
- Be regular taking the antibiotics and other medicines prescribed by the physician
- Avoid any vigorous (physical) activities for at least 6 weeks
- Resume normal activities and sports, based on physician’s recommendations
How long does it normally take to fully recover, from the Procedure?
It takes about 3-6 weeks for a complete recovery from the surgical procedure.
What happens to tissue (if any), taken out during the Procedure?
The procedure does not involve the surgical removal of any tissue.
When should you expect results from the pathologist regarding tissue taken out, during the Procedure?
Since no tissue is removed during the procedure, a pathologist does not get involved in the care of the patient.
Who will you receive a Bill from, after the Testicle Fixation (Orchiopexy) surgical procedure?
It is important to note that the number of bills that the patient may receive depends on the arrangement the healthcare facility has with the physician and other healthcare providers.
Sometimes, the patient may get a single bill that includes the healthcare facility and the consultant physician charges. Sometimes, the patient might get multiple bills depending on the healthcare provider involved. For instance, the patient may get a bill from:
- The outpatient facility
- An urologist or general surgeon
- An anesthesiologist (if anesthesia was administered)
- A radiologist (if radiological tests were performed during the procedure)
The patient is advised to inquire and confirm the type of billing, before a Testicle Fixation surgical procedure is performed.
Thanks and Gratitude:
We sincerely acknowledge and thank Dr. Douglas J. Jones for reviewing the article. His valuable input and feedback has helped enrich the contents of this article.
Douglas J. Jones, MD FACS
Board Certified General Surgeon and Faculty Member
University of Illinois, College of Medicine at Urbana-Champaign
506 S. Mathews Ave., Urbana, IL 61801, USA