WHAT YOU SHOULD
KNOW
If one or both of a boy's testicles fail to descend from
the lower abdomen into the scrotum, the problem can be remedied
by an operation called an orchiopexy (OR-kee-o-PEK-see).
The testicles ordinarily fall into place before birth.
They may still descend on their own before age 1. If they
don't, the doctor will probably prescribe hormone shots. If
they still refuse to descend, surgery is the next
step.
Risks
If both testicles remain undescended, the boy may be
sterile when he grows up, and may not develop normal male
traits. A single unde__scended testicle increases the risk of
testicular cancer later in life. All these risks can be avoided
if the problem is corrected before age 3. Of course, the
surgery poses risks of its own. The boy could suffer heavy
bleeding or develop infection. However, doctors are alert for
such dangers.
IF YOU'RE HEADING FOR THE
HOSPITAL...
Before You Go
-
The Week Before Surgery:
-
You'll probably need to stop
giving the boy ibuprofen; the doctor will tell you when.
Also, never give aspirin to any child under 18. It can
cause a serious neurological illness called Reye's syndrome
if the child catches a virus. Ask the doctor about any
other over-the-counter medicines you've been giving the
child.
-
Your doctor will tell you
whether any blood needs to be drawn for preop
tests.
-
The Night Before Surgery:
-
Your physician may suggest
that you give the boy a sleeping pill.
-
Just before surgery, the
child should not eat or drink anything (even water). Your
doctor will tell you when the boy should start
fasting.
-
Call Your Doctor If...
-
The boy has a cold or flu or
is running a high temperature. The operation may need to be
postponed.
When You
Arrive
-
Check with your doctor before
giving the child insulin or any other medication on the day
of surgery.
What to Expect While You're
There
You may encounter the following procedures and equipment
during your son's stay:
-
Taking Vital Signs: These include your son's
temperature, blood pressure, pulse (counting his
heartbeats), and respirations (counting his breaths). A
stethoscope is used to listen to his heart and lungs. His
blood pressure is taken by wrapping a cuff around his
arm.
-
Blood Tests: The doctor may need to have blood taken
for tests. It can be drawn from a vein in the boy's hand or
from the bend in the elbow. Several samples may be
needed.
-
Chest X-ray: Doctors study this picture of the boy's
lungs and heart for signs of infection, pneumonia, and
other conditions that might interfere with the
operation.
-
Heart Monitor: (Also called an electrocardiogram
[e-LEK-tro-KAR-di-o-gram] or EKG). Typically, three to five
sticky pads are placed on different parts of the boy's
body. Each pad has a wire that is hooked to a TV-type
screen or to a small portable box (telemetry unit) that
shows a tracing of each heartbeat.
-
IV: A tube placed in the boy's vein for giving
medicine or liquids. It will be capped or have tubing
connected to it.
-
Pulse Oximeter: With a little clip connected to his
ear, finger, or toe, this machine measures the oxygen in
your boy's blood.
-
General Anesthesia: For this operation, the boy
needs to be put completely to sleep. The anesthesia will be
given either as a liquid in the child's IV or as a gas
through a face mask or an endotracheal (END-o-TRA-kee-ull)
tube placed in his mouth and throat.
During Surgery
The doctor makes incisions in the boy's groin and
scrotum. Each testicle is then pulled down into the scrotum
through an opening called the inguinal (IN-gwih-null) canal.
The incisions are usually closed with thread that the body
eventually absorbs.
After Surgery
The boy should not get out of bed until doctors give the
OK. If he's in a crib, keep the side rails up at all times for
safety. The incisions will be covered with bandages to keep
them clean and dry. A doctor may remove them briefly soon after
surgery to check the stitches.
-
Ice: For pain or swelling, you may put ice in a
plastic bag, cover it with a towel, and place it over the
surgery area for 15 to 20 minutes out of every hour as long
as necessary. Do not let the boy sleep on the ice pack.
Treatment with ice is most effective when started right
after surgery and used for 24 to 48 hours.
-
Heat: After the first 24 to 48 hours you may use
heat for pain or swelling. Use a heating pad (turned on
low) or a hot water bottle, or put the boy in a warm water
bath for 15 to 20 minutes out of every hour as long as
needed. Do not let him sleep on the heating pad or hot
water bottle. Heat brings blood to the area of the surgery
and helps it heal faster.
-
Activity: The boy will need to rest in bed for a
while. But even while he's confined to bed, it's important
to have him exercise his legs in order to stop blood clots
from forming. Tell him to lift one leg off the bed and draw
big circles with his toes, then repeat with the other leg.
You can also let him lie on his side and pretend to pedal a
bike. When you're told it's OK for him to get out of bed,
make sure someone is with you the first time he tries. If
he feels weak or dizzy, have him sit or lie down right
away. Eating: You can begin feeding the youngster as soon
as the doctor hears bowel sounds (stomach growling) through
a stethoscope. Start with ice chips, then add liquids
(water, broth, apple juice, or 7-up). If he has no problems
after drinking liquids, he'll be allowed to eat soft foods
such as ice cream, applesauce, or custard. If he does well
with soft food, he can resume his regular
diet.
-
Strict Intake or Output: Your doctor may need to
know the amount of liquid your boy is taking in versus the
amount he loses in his urine. This is often called
"I&O." Try to keep track of how much the boy drinks.
Check with a nurse before flushing urine down the toilet or
disposing of the boy's diapers.
-
Medicines:
-
Antibiotics: These medicines may be prescribed to
prevent a bacterial infection. They can be given by IV, as
a shot, or by mouth.
-
Pain Medicine: Your doctor can prescribe
pain-killers to be given in your boy's IV, as a shot, or by
mouth. Tell your doctor or nurses if the pain doesn't seem
to go away, or if it comes back.
-
Anti-Nausea Medicine: Because pain medicine
sometimes upsets the stomach, your doctor may prescribe
additional medicine to calm your son's stomach and control
vomiting.
After You
Leave
-
Always give medicine exactly
as directed. If it doesn't seem to help, let the doctor
know, but keep giving it until told otherwise. If the boy
has been prescribed antibiotics, be sure to use them up,
even if he's feeling better.
-
When your doctor says it's
alright to bathe the boy, carefully wash the incisions with
soap and water. Afterwards put on a clean, new bandage.
Change the bandage any time it gets wet or
dirty.
-
If the boy has steristrips
(thin strips of tape) over the incision, keep them clean
and dry. As they start to peel off, let them fall off by
themselves. Don't pull them off.
-
Urination should not hurt the
youngster. If you think it's causing the boy pain, call the
doctor.
-
Children usually get better
quickly after surgery. Let your child rest as much as
needed. He may return to normal activity when he seems
ready. Once he feels better, he can do all the things he
normally does every day. Lifting things should not damage
the stitches.
Call Your Doctor
If...
-
The boy's stitches are
swollen or red, or you see pus coming out of them. They may
be infected.
-
The stitches come
apart.
-
The bandage becomes soaked
with blood.
-
The boy develops a high
temperature.
-
He is fussy or crying a
lot.
-
His pain won't go away or
seems to be getting worse.
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