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Subject: Re: UNDESCENDED TESTICLE
Forum: The Urology Forum
Topic Area: Pediatric Urology
Posted by MARK C. on July 07, 1999 at 09:27:41I am a UK family doctor. My seven year old son has an undescended testicle (inguinal)which can be brought into a scrotal position crouching in the bath. His urologist thinks he can perform an orchidopexy but wants consent pre-op for orchidectomy. If the urologist fails at the time of the op to bring the testicle down, should I go along with the orchidectomy or are there other options? I am concerned about the cosmetic/psychological problems. Thanks.
Posted by HFHS M.D.-Ak on July 08, 1999 at 09:28:47Dear Mark,
A consent for surgery is a legal document stating that all of the risks and complications of a certain procedure have been discussed with the patient or guardian in your case, before an operation is performed. This helps explain to people that surgery is not without complication. Often the more common complications associated with each procedure are discussed such that in the event that they occur, the surgeon could deal with the problem immediately without hesitation.
Keep in mind that different people have different anatomy and unforeseen problems can arise. In regards to an orchidopexy, particularly one that is in the inguinal canal, the risk of orchidectomy is probably less than the risk of anesthesia. The most common complication with orchidopexy, including complicated testes is high-riding testis after surgery. This occurs in about 3% with 1% requiring reoperation. It is also possible to have testicular atrophy after the procedure if the blood supply is compromised. More than likely, the consent you signed for this procedure is probably a standard form for all orchidopexies, one that includes bringing down intra-abdominal testicles. The success rate is greater than 95% for this procedure and fertility rate s approach 80% for unilateral UDT. I dont think you need to be overly concerned about your sons situation because the chance is minimal. A well trained urologist bringing down a palpable inquinal testis should be successful.
However, in the event that the blood supply is cut or torn, the testis could be left in place and evaluated in the future. The testis would most likely atrophy but could become infected or cause pain. Performing an orchidectomy at the time of the surgery would save your son from any further surgery or complication.
This information is provided for general medical educational purposes only. Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition. More individualized care is available at the Henry Ford Hospital and its satellites (1 800 653-6568). Sincerely,
HFHS M.D.-AK
*keyword:Undescended Testicle
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