Undescended Testicles Treatment Options

If your child was born with undescended testicles and they haven’t dropped by the time he is 3-6 months, you should talk with your pediatrician to discuss treatment options as soon as possible. Usually surgery is recommended and surgery should be performed before the child turns one year old.

The goal of surgery is to bring undescended testicles into the correct place in the scrotum. There are two types of surgery: orchiopexy and FS orchiopexy.

• Orchiopexy: If the testicle is low in the belly or in the groin, the testicle can be moved with orchiopexy surgery.
• FS Orchiopexy: If the testicle is high in the belly, “Fowler-Stephens” (or FS) orchopexy is performed. This is because the blood vessels attached to the testicle are not long enough to reach into the scrotum. This is either done in one or two steps. – the second step being at least 6 months later.

Both surgeries can be done as either open surgery or laparoscopic surgery. If the testicle is in the groin, your child will have open surgery. If the testicle is unable to be located, a surgeon will do laparoscopic or open surgery to locate the testicle and then move it to the scrotum.

• Open surgery: During open surgery, an incision is made in your child’s belly or groin/scrotum to perform surgery.
• Laparoscopic surgery: During laparoscopic surgery, a laparascope – a thin tube with a tiny camera – is used. An incision is made in the belly and the larascope allows the surgeon to see inside the belly to locate the testicle without having to make multiple incisions.

Side effects of surgery are rare, but include bleeding, infection, injury to blood vessels or organs, and risks associated with general anesthesia. Testicles can also travel back up into the groin or belly after surgery, in which case another surgery may be needed. Few men who have had this surgery report fertility problems later in life. If the undescended testicle has died due to a lack of blood supply, it will be removed. This is why it is important to have the surgery while the child is still very young.

Some children have a retractile testicle, meaning he was born with both testicles descended but one or both move back and forth between the scrotum and groin. This is normal and there is no need for surgery.

Hormonal Treatment for Undescended Testicles

If your child’s testicle is close to the scrotum, your doctor may recommend hormonal treatment. This treatment is rare though and there is not enough research to know how well it works. The hormone is a human chorionic gonadotropin that is given as a shot 2-4 times a week for 4 weeks. Side effects include headache, irritability, restlessness, swelling, breast, penis, or hair growth, aggressive behavior, and erections.

Recovering from Surgery

Your child may not feel week after surgery as a result of the anesthetic – this is normal. For a few days, he should not sit on toys or ride a bicycle and may need pain relief. The success rate for treating undescended testicles is around 90%.