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At UPMC Children's Hospital of Pittsburgh, we believe parents and guardians can contribute to the success of this surgery and invite you to participate. Please read the following information to learn about the surgery and how you can help.
In the mother’s womb, a baby boy’s testicles develop inside his abdomen. Shortly before birth, they move down into the scrotum. In about 4 percent of infant boys, this movement does not occur. For half of these babies, movement does occur before age 1. If the testicles do not move down into the scrotum by age 1, the pediatrician and parents must discuss whether or not to use surgery, called an orchiopexy (OR-kee-o-PEK-see), to bring the testicles down into the scrotum.
Undescended testicles may not cause pain, but they may cause swelling or a lump in the groin area (the place where the lower abdomen meets the inner thigh). If not corrected surgically, the undescended testicles may cause infertility and other medical problems later in life, including the development of tumors or hernias. The area is also more vulnerable to injury if not corrected.
The surgery to move the undescended testicle into the scrotum is done under general anesthesia. General anesthesia makes your child’s whole body go to sleep and is needed for the surgery so that his reflexes will be completely relaxed. General anesthesia makes the surgery easier and safer to do because your child will not feel any pain or have any memory of it.
Caudal anesthesia is given with general anesthesia to block pain in the low back, tummy and lower trunk area and provides up to 4 hours of pain relief in that area after the surgery. Caudal anesthesia is usually more successful in younger children. The surgeon may give your child a local anesthetic injection if a caudal injection is unsuccessful or unnecessary.
Once your child has been registered, he will be taken to a “holding area” where you will meet the anesthesiologist and your surgeon. A peditric anesthesiologist—a doctor who specializes in anesthesia for children—will give the medications that will make your child sleep during the surgery. At this time, you will be able to ask any questions about the surgery.
Once questions are answered and the operating room is prepared, your child will be taken into the operating room and given an anesthetic to make him go to sleep.
When your child is asleep, the surgery will begin.
When general anesthesia is needed, there are important rules for eating and drinking that must be followed in the hours before the surgery. One business day before your child’s surgery, you will receive a phone call from a nurse between the hours of 1 and 9 p.m. (Nurses do not make these calls on weekends or holidays.) Please have paper and a pen ready to write down these important instructions.
The nurse will give you specific eating and drinking instructions for your child based on your child’s age. Following are the usual instructions given for eating and drinking. No matter what age your child is, you should follow the specific instructions given to you on the phone by the nurse.
For children older than 12 months:
For infants under 12 months:
For all children:
Once your child has been registered for the surgery, a member of the anesthesia staff will meet with you to take your child’s vital signs, weight and medical history. As the parent or legal guardian, you will be asked to sign a consent form before the anesthesia is given.
While your child is asleep, his heart rate, blood pressure, temperature and blood oxygen level will be checked continuously. Your child might have a breathing tube placed while he is asleep. If a breathing tube is used, your child might have a sore throat after the surgery.
After surgery, your child will be moved to the recovery room. You will be called so that you can be there as he wakes up.
The most important role of a parent or guardian is to help your child stay calm and relaxed before the surgery. The best way to help your child stay calm is for you to stay calm.
After your child is discharged and goes home, he might still be groggy and should take it easy for the day.
Once your child is home, his diet should be restricted to clear liquids, such as water, Gatorade®, Popsicles® or Kool-aid® for a couple of hours to ensure his stomach is settled after the surgery and the car ride home. If your child does well with these liquids, after a couple hours, he may try a light diet of soft foods like applesauce, soup, toast, bananas, rice or hot cereal. He should avoid greasy foods that stay in the stomach for a long time, such as pizza and fast food. Your child may resume a normal diet the next day.
Your child should take Tylenol® or Motrin® 4 hours after the surgery, which will help with discomfort when the anesthesia wears off. Pain medication is rarely needed after 2 days. If your child is over 5 years of age, your surgeon will give you a prescription for Tylenol® with codeine elixir, in the event that your child needs additional pain medication. You do not need to fill this prescription until you see how your child is doing.
After the operation, activity needs to be somewhat restricted.
If you notice a fever higher than 101.4˚F, bleeding or foul smelling drainage from the area around the incision, call the doctor who did the surgery right away. Also call the doctor if your child has:
Your child will have a follow-up visit with the surgeon about 4 to 6 weeks after the surgery.
If you have any specific questions about your child’s surgery, you should discuss them with the surgeon before the surgery. You may call the Division of Pediatric Surgery at Children’s and ask to speak with your child’s surgeon, or speak with him or her during the pre-surgical examination on the day of the surgery.
If your child has any special needs or health issues you feel the doctor needs to know about, please call the Division of Pediatric Surgery at Children’s before the surgery and ask to speak with a nurse. It is important to notify us in advance about any special needs your child might have.
Children's Hospital's main campus is located in the Lawrenceville neighborhood. Our main hospital address is:
UPMC Children’s Hospital of Pittsburgh
One Children’s Hospital Way
4401 Penn Ave.
Pittsburgh, PA 15224
In addition to the main hospital, Children's has many convenient locations in other neighborhoods throughout the greater Pittsburgh region.
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