Orchiopexy surgery in Kohima

Orchiopexy is a surgery to treat an undescended testicle in babies or testicular torsion in adults. Testes are two egg-shaped glands inside the scrotum containing the sperm (male reproductive cells that can fertilize a female egg). Usually, the testicles descend from the abdomen into the scrotum (a part of the male reproductive system located beneath the penis that contains and protects the testes), just before birth. If the testicles remain undescended for more than 6 to 8 months, they must be brought down surgically.  Orchiopexy is done between 6 to 12 months of age. It is done under general anesthesia, and you can take your baby home the next day without major complications. Your baby will recover in 2 to 3 days.

Orchiopexy is the surgery done to treat an undescended testicle or testicular torsion. 

Orchiopexy For Undescended Testicles

This surgery is done in babies between the ages of 6 to 12 months. The undescended testicle is located and placed in the abdomen. This surgery is essential as being in the scrotum ensures that the testicle remains cool. This plays an important role in sperm production later on in life. In this procedure, the surgeon makes incisions in the groin to locate the testicle. The testicle is then placed securely in the scrotum, and the incisions are closed. The recovery period is 2 to 3 days.
 

Orchiopexy For Testicular Torsion

Testicular torsion occurs when the spermatic cord gets twisted, cutting off the blood supply to the testicle. This is a medical emergency; unless operated upon immediately, you will lose your testicle. The surgeon makes incisions in the groin and frees the testicle from the twisted cord. Recovery from this procedure is painful and lasts for a week or more. Sometimes, babies are born with testicular torsion too. 

Orchiopexy is performed majorly for undescended testicles in babies. In adults, it is performed when there is testicular torsion.

In Babies 

The testicles usually descend from the abdomen into the scrotum during birth. In some babies, the testicles remain undescended even after birth. In such cases, it is advisable to surgically bring down the testicles at around 6 to 12 months of age. The testicles need to remain in the scrotum outside the body as the temperature is cooler in the scrotum. This impacts sperm production in later life.

In Adults

Sometimes, the testicles get twisted around the spermatic cord. This can be dangerous as the blood supply to the testicles can get cut off, leading to necrosis and death. This is a medical emergency and needs immediate surgery.

Orchiopexy is a surgery performed on babies at the age of 6 to 12 months. Sometimes it may be done in older kids up to 2 years of age. This surgery is also done in adults having testicular torsion.

Preparing for the surgery- Babies

• The parents/ guardians have a vital role to play in preparing the child for surgery. You will be advised to stay calm as this is the best way to keep your child calm. You may be allowed to hold your baby's hand during the surgery. A comfort item like your baby's favorite toy or blanket can greatly help soothe him during the surgery.
• Since your baby will be receiving general anesthesia, it is important to keep these dietary instructions in mind-
  • Stop feeding your baby solids and unclear fluids like milk and soups from midnight before the surgery.
  • Breast-fed babies can be fed for up to 2 hours before surgery
  • Formula-fed babies can be fed up to 4 hours before surgery
  • Only fluids like water and clear juices can be fed until 4 hours before surgery.
• Diagnosis of an undescended testicle is usually through physical examination only. Routine tests like a blood count, urine examination, and scrotal ultrasound may be advised.
• You can ask the surgeon about the details of the procedure. You will be asked to sign an informed consent form that allows the surgeon to proceed with the surgery.

Preparing for the surgery- Adults

• Discuss your medical history with your surgeon and inform him about-
  • All the medications that you are currently taking for your health conditions
  • Any dietary supplements and herbs that you are taking
  • Allergies towards medicines.
• An emergency scrotal ultrasound will be advised. This is a test to check the blood flow within your testicles. This gives the surgeon an idea about the extent of damage that has already happened.
• Routine tests like a complete blood count, X-ray, ECG (electrocardiogram), and routine urine tests will be done.
• You will be asked to arrange for a friend or relative to drive you home after the surgery.

Orchiopexy is a surgery to treat undescended testes in babies and testicular torsion in adult men.

The surgery takes about 45 minutes to an hour to perform. Here is what happens during an orchiopexy procedure.

Orchiopexy Procedure-Babies

• Your baby is first anesthetized. General anesthesia is the preferred mode of numbing your baby to the pain.
• The surgeon will make a small incision in the groin region and locate the testicle.
• The testicle will be examined to make sure it is healthy
• A hernia sac is commonly found at this place. A hernia sac is a pouch filled with tissues pushed out from the abdomen. This pouch is pushed back, and a hernia repair is done first.
• Next, an incision is made in the scrotum to create a ‘pocket’ to hold the testicle. The testicle is then placed inside this ‘pocket’
• Once the procedure is complete, the surgeon will close both incisions with dissolvable sutures.

Orchiopexy Procedure-Adults

• On the day of the surgery, an IV line will be set up by attaching a catheter to a vein in your hand. This helps to keep administering fluids into your body.
• As per your discussions with the surgeon, general is administered.
• The surgeon will make an incision on your scrotum and release the twisted spermatic cord to free your testicle.
• Though the scrotal approach is the preferred method, sometimes the surgeon may need to make an incision in your groin.
• Once the testicle has been freed, it is secured to the wall of the scrotum with sutures. This helps to prevent the torsion from happening again.

Orchiopexy surgery in kids and adults takes about an hour to complete. Once the surgery is done, you or your baby will be shifted to the postoperative care unit, where the vitals, like the pulse, blood pressure, temperature, and respiratory rate, will be monitored. Once the condition is stable and there are no visible side-effects of anesthesia, you/your baby will be sent home.

Orchiopexy surgery   in Kohima is done under general anesthesia. You can go home once the vitals are stable. Recovery in babies is faster than in adults. Complete recovery takes 2 to 4 weeks

Recovery in babies

• Your baby will experience pain and discomfort once the effects of anesthesia start wearing off. Pin medications will be prescribed for the same.
• Ensure that you give all the medications prescribed on time.
• Your baby can have a normal diet after the surgery. He can have clear soups, juices, and water the day after the surgery. You can start solids and semi-solids gradually.
• It will take about 2 -3 days for the pain to completely subside and for your baby to resume his routine activities. Healing completely will take around 2 weeks.
• It is important to take it easy during the recovery process. Avoid playing with bikes, walkers, and swings.
• The scrotum will look bruised, and the incisions will appear lumpy after surgery. This is normal. The incisions will gradually smoothen over time.
• You can bathe your baby after 2 days. Remember to wipe the surgical area well after the bath. Do not let moisture accumulate.

Recovery in adults

• Recovery from orchiopexy in adults is a painful process that takes more than a week.
• The swelling, bruising, pain, and discomfort are present for a week.
• Once the pain subsides, you can gradually return to your routine work.
• Avoid strenuous activities like lifting heavy objects, straining for stools, exercising, and sexual activities for 4 weeks. 
• Take all your prescribed medications on time.
• Eat bland food for a week. Avoid spicy, oily, and excessively salty food. Include many fresh vegetables and fruits with high fiber content in your diet.
• Drink adequate amounts of water to keep yourself hydrated.

Orchiopexy surgery in Kohima helps bring back the undescended testicle to its rightful place in the scrotum. It is an invasive surgery in Kohima that comes with its benefits as well as risks.

Advantages of orchiopexy procedure

• Orchiopexy helps prevent infertility. 
• The chances of testicular cancer are lowered after orchiopexy
• Orchiopexy is done with the aim of not hampering a child’s self-esteem, among other reasons. A child with an undescended testicle may become the subject of ridicule among his peers.
• Orchiopexy in adults having testicular torsion is a life-saver as it prevents the loss of testicles due to necrosis.

Risks of orchiopexy procedure

• Side effects of anesthesia like respiratory distress, nausea, vomiting, etc.
• Infection at the incisions
• Formation of hematoma (collection of blood under the skin) at the site of incision
• Formation of ugly scars
• Permanent damage to the testicles can happen if your testicles have been without blood supply for more than 6 hours. In such cases, the testicle will have to be removed.
• Testicular torsion leads to chances of infertility. Even if the orchiopexy surgery is successful, the damage to the testicle due to loss of blood supply can lead to reduced sperm count.
• Testicular atrophy may be seen after orchiopexy

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