What is orchidopexy? Orchidopexy is a surgical procedure that is used to treat a retained testicle in the abdominal cavity (cryptorchidism) or prevent testicular retraction (a condition in which the testicle descends normally into the scrotum but may be retracted into the groin involuntarily muscle contraction). The procedure involves moving the testicle from the area in the abdomen or groin (depending on where it is currently located) to the scrotum (pouch of skin under the penis). The doctor then surgically attaches the testicle to the scrotum with a “stitch.” What is cryptorchidism? Cryptorchidism is a term that describes an undescended (retained) testicle that has not descended into the scrotum. When both testicles are affected, this condition is called bilateral cryptorchidism, and the procedure to repair the condition is called bilateral orchidopexy. Absence of one or both testes in the scrotum occurs at birth in approximately 1.8% to 8.4% of full-term infants. In premature newborns, this number can be as high as 30%, according to a study published in the German Medical Journal. By the time babies reach one year of age, the incidence of cryptorchidism drops to about 1-2%. Specialists do not choose to perform an orchiopexy right away, but rather wait a while to observe the condition and see if it corrects spontaneously without surgery. The diagnosis of cryptorchidism is easily established by observing the absence of a testicle in the scrotum. Then the question arises whether the testicle is left in the abdomen, whether it is retained in the groin or not at all. According to a study, in the field of urology, imaging (such as radiography or computed tomography) is not a useful diagnostic tool for diagnosing cryptorchidism. The study author explains that if the undescended testis cannot be palpated (felt with the hand), the next step in diagnosing the condition is evaluation by a specialist, usually a pediatric urologist, and then possibly performing an orchidopexy. This is usually done if the testicle has not descended after the baby is six months old. When is orchidopexy required? Many experts believe that orchidopexy should be performed between 6 and 12 months of age. In cases of cryptorchidism diagnosed after six months of age, affected infants should be referred to a specialist for correction of the condition so that surgery can be performed within a year of its diagnosis. This allows the testicles enough time to descend spontaneously while facilitating early intervention. Early intervention is aimed at reducing the risks associated with untreated cryptorchidism. The risks of untreated undescended testicles could potentially include testicular cancer and infertility. Research has found that early surgery has led to positive effects. However,another evaluation found that patients who were treated for bilateral (on both sides) undescended testes were significantly less likely to have offspring. Orchiopexy is considered beneficial for fertility in the long term for those patients who had a unilateral undescended testicle and underwent the procedure before their second birthday. What is the incidence of cryptorchidism? The incidence of undescended testis is increased in infants with certain conditions such as: Low birth weight; Some genetic diseases. An example of one such genetic disorder that poses a high risk is Prader-Willi syndrome (a syndrome that causes obesity, intellectual disability, and short stature). Cryptorchidism is usually a condition that occurs without the presence of genetic diseases, however, its frequency is increased in certain syndromes. References: 1. Cohen, T., Orchiopexy What the Anesthesiologist Should Know before the Operative Procedure 2. Cooper, CS, MD, Docimo, SG, MD. Undescended Testes (Cryptorchidism) in Children: Clinical Features and Evaluation 3. UMC Children’s Hospital of Pittsburgh Staff. Undescended Testicle (Orchiopexy) Repair Surgery 4. Kurz, D. MD. (2016). Current Management of Undescended Testes