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orchiopexy (undescended testicle)

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39K views 38 replies 17 participants last post by  Fabianne 
#1 ·
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!
 
#27 ·
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.
 
#28 ·
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* View Post
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.
 
#37 ·
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.
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
 
#29 ·
Quote:

Originally Posted by *Karen* View Post
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.
 
#36 ·
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 momeint but then quickly forget.

Despite all my hesitancy, I'm leaning toward just scheduling and getting it over with this summer.
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
 
#30 ·
Quote:

Originally Posted by Alki Mama View Post
Despite all my hesitancy, I'm leaning toward just scheduling and getting it over with this summer.
Yep, me too.
 
#31 ·
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*!
 
#32 ·
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!
 
#33 ·
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!
 
#34 ·
Quote:
Originally Posted by Alki Mama View Post
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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