From the Guidelines
The treatment for a testicle found in the inguinal canal is surgical correction through a procedure called orchiopexy, which should be referred to an appropriate surgical specialist by six months (corrected for gestational age) for timely evaluation and treatment. This recommendation is based on the American Urological Association (AUA) guideline for the evaluation and treatment of cryptorchidism, which emphasizes the importance of early referral and treatment to minimize potential complications such as infertility, testicular torsion, trauma, and malignancy 1.
Key Considerations
- The AUA guideline recommends that primary care providers palpate testes for quality and position at each recommended well-child visit to detect undescended testes early 1.
- Approximately 70% of undescended testes are palpable, and for those that are not, about 30% will be found in the inguinal-scrotal area, 55% will be intra-abdominal, and 15% will be absent or vanishing 1.
- Spontaneous descent of testes may occur in the first six months of life, but testes that remain undescended by six months (corrected for gestational age) are unlikely to descend spontaneously and should be referred to a surgical specialist for evaluation and treatment 1.
Treatment Approach
- Orchiopexy is typically performed as outpatient surgery under general anesthesia, with the goal of bringing the undescended testicle down into the scrotum and fixing it in place.
- Early surgical correction is crucial to preserve fertility potential and reduce the risk of testicular cancer.
- Post-operative care includes pain management, keeping the surgical site clean and dry, and limiting strenuous activity for 1-2 weeks, with follow-up appointments necessary to ensure proper healing and testicular position.
Special Considerations
- In rare cases where the testicle is found after puberty, removal (orchiectomy) rather than repositioning may be recommended due to the significantly increased cancer risk.
- A therapeutic trial of human chorionic gonadotropin (hCG) may be indicated for treatment of undescended testes before surgery in certain cases, such as in infants with low muscle tone and potential for underlying respiratory compromise 1.
From the Research
Treatment for Testicle in Inguinal Canal
The treatment for a testicle found in the inguinal canal depends on the underlying condition.
- If the testicle is undescended, the treatment may involve surgery, such as orchiopexy, to bring the testicle down into the scrotum 2, 3.
- If the testicle is torsed, the treatment may involve emergency surgery to untwist the testicle and restore blood flow 4, 5, 6.
- In some cases, the testicle may need to be removed if it is damaged or necrotic 4.
Surgical Options
- Scrotal incision orchiopexy is a surgical technique that can be used to treat undescended testes located in the inguinal canal 2.
- Traditional inguinal orchiopexy may be necessary in some cases, especially if the testicle is located high in the inguinal canal or if there is inadequate mobilization of the testicle 2.
- Orchiectomy may be necessary in cases where the testicle is damaged or necrotic due to torsion 4.