Orchiopexy is a common surgical procedure performed to treat an undescended testicle, where the testicle has not moved into its proper position within the scrotum. The procedure involves moving the testicle from the groin or abdomen and securing it within the scrotal sac. Understanding the post-operative period can be challenging for parents, as the physical state of the scrotum changes significantly after the operation. The testicle’s visibility will evolve as the body heals from the surgical trauma.
Managing the Initial Recovery Phase
The immediate post-operative period, typically the first 48 to 72 hours, is characterized by local trauma and the body’s inflammatory response to surgery. Mild to moderate pain is expected, but this is usually managed effectively with prescribed pain relief medications. The surgical site, which may include incisions in the groin and the scrotum, will exhibit noticeable swelling and bruising.
The scrotum is likely to appear discolored and significantly enlarged due to bruising and swelling, which is a normal response to tissue manipulation. This initial edema, or fluid retention, makes it difficult to clearly see or feel the testicle in its new position. The surgeon confirms the correct placement before closing the incision, so the initial lack of clarity is not a cause for alarm.
Wound care involves managing the incision sites, which may be covered with dissolvable sutures, surgical glue, or small adhesive strips that will fall off naturally. Keeping the area clean and dry is paramount to preventing infection. A small amount of clear or pinkish drainage from the wound is often considered normal. The initial focus is on comfort and minimizing activity to protect the surgical repair.
Visual Confirmation: When the Testicle Becomes Apparent
Visual confirmation of the testicle’s stable placement is directly tied to the reduction of post-surgical swelling. The most significant swelling and bruising in the scrotum peak during the first few days. The resolution process begins shortly thereafter, and swelling generally starts to subside noticeably around the end of the first week.
A clearer visual and palpable confirmation of the testicle is typically achieved between two and four weeks post-surgery. During this timeframe, the accumulated fluid is reabsorbed by the body, allowing the parent to feel the testicle more distinctly within the scrotal sac. The testicle may temporarily appear slightly smaller than the unoperated side due to inflammation, but this is usually temporary.
Successful long-term placement relies on the internal fixation sutures securing the testicle within the newly created scrotal pouch. Although the surgeon confirms placement during the procedure, the two to four-week mark is when local swelling has diminished enough for the parent to feel confident in the testicle’s settled position. Swelling and firmness underneath the incision can persist for up to a month as the deep tissues continue to heal and remodel.
Resuming Daily Life and Activity Restrictions
While initial recovery focuses on rest, most children return to regular activities within a few days of the operation. Returning to school or daycare is often possible within two to three days, provided the child is feeling well and pain is controlled with oral medication. Restriction guidelines are aimed at protecting the internal surgical repair and preventing tension on the repositioned testicle.
Full immersion in water, such as swimming or tub baths, is restricted for one to two weeks to allow external incision sites to heal completely. More strenuous activities require a longer restriction, often four to six weeks post-surgery.
Activity Restrictions
- Rough play
- Jumping
- Running
- Contact sports
- Activities that involve straddling, such as riding a bicycle or tricycles, should be avoided for approximately three to four weeks.
Long-term monitoring is required to ensure the testicle remains descended and stable. Follow-up appointments with the pediatric surgeon are scheduled to evaluate healing and confirm the testicle’s viability and position, often occurring around four to six weeks after surgery. Parents should continue to check the scrotum regularly and report any changes in position or size to the surgeon.
Warning Signs and Urgent Concerns
Parents must differentiate between expected post-operative discomfort and signs of a potential complication requiring immediate medical attention. Any fever above 101.4 degrees Fahrenheit, especially if occurring more than one day after surgery, is a significant warning sign that should prompt a call to the care team. While a low-grade fever is possible immediately after the procedure, a persistent or higher temperature may indicate an infection.
Signs of a wound infection include increasing pain, warmth, spreading redness beyond the incision edges, or the presence of pus or foul-smelling discharge. Bleeding heavy enough to soak through a large bandage necessitates immediate medical contact. Severe pain unresponsive to prescribed medication is another indicator that a complication, such as a hematoma or infection, may be developing.
The most concerning sign is if the testicle retracts or disappears back into the groin after it had been confirmed in the scrotum following swelling reduction. This suggests a failure of the fixation and requires urgent evaluation to prevent harm to the testicle. Any difficulty passing urine after the surgery should be reported to the surgeon promptly.