Orchiopexy: Why It's Done, the Best Age, and What Recovery Looks Like
Updated: 6 days ago
Written and medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: October 2026 · How we review
Quick Answer: What is orchiopexy?
Orchiopexy is surgery that moves a testicle into the scrotum and stitches it in place. It treats undescended testicles, ideally between 6 and 18 months of age, and testicular torsion, which needs emergency surgery. The operation takes about an hour under general anesthesia, and most patients go home the same day. [1]
What the research says
Surgery before age one may support growth and fertility. A systematic review of 260 articles found that testicular growth and fertility potential improve when orchiopexy is done before one year of age, and that orchiopexy before puberty may lower the higher testicular cancer risk linked to undescended testes. (Gates et al., J Pediatr Surg, 2022) [2]
Very early surgery did not change complication rates. A meta-analysis of 16 studies found no significant difference in testicular atrophy (1,855 testes; OR 1.05) or post-surgery complications (757 testes; OR 1.15) between surgery before 12 months and later surgery, though the evidence quality was low. (Kaushal et al., Pediatr Surg Int, 2026) [3]
A two-stage approach works better for testicles high in the abdomen. Across 17 studies and 499 testes, two-stage laparoscopic surgery placed the testicle successfully in 90.3% of cases versus 79.4% for single-stage surgery, with lower atrophy (11% vs 17.3%). (Fung et al., Eur J Pediatr Surg, 2025) [4]
Key takeaways
Orchiopexy fixes a testicle in the scrotum to treat an undescended testicle or testicular torsion. [1]
For undescended testicles, surgery is recommended between 6 and 18 months if the testicle hasn't dropped by about 6 months. [1]
Testicular torsion is an emergency: if blood flow isn't restored within about six hours, the testicle may need to be removed. [1]
The procedure takes about an hour, and most people go home roughly two hours afterward. [1]
Most children return to school or daycare in 3 to 5 days, but should avoid sports and straddle toys for at least two weeks. [1]
Orchiopexy at a glance
Topic | What to expect |
Other names | Orchidopexy, undescended testicle repair surgery |
Conditions treated | Undescended testicles, testicular torsion |
Best age (undescended testicle) | 6 to 18 months |
Anesthesia | General anesthesia |
Operation time | About 1 hour |
Hospital stay | Usually none; home about 2 hours after surgery |
Back to school or daycare | 3 to 5 days |
No sports or rough play | At least 2 weeks |
Stitches | Dissolve in about 2 weeks |
Follow-up | At 2 weeks, sometimes again at 2 to 3 months |
Source: [1]
What conditions does orchiopexy treat?
Orchiopexy treats two conditions: undescended testicles and testicular torsion. [1]
An undescended testicle is one that doesn't drop from inside the belly into the scrotum before birth or in the first few months of life. During surgery, the testicle is moved from the belly or groin and attached inside the scrotum. Learn more in our guide to undescended testicles in babies. [1]
Testicular torsion happens when the spermatic cord, which carries the testicle's blood supply, twists and cuts off blood flow. The surgeon untwists the cord and secures the testicle inside the scrotum so it can't twist again. Read the full guide to testicular torsion symptoms and treatment. [1]
During the same operation, the surgeon may also repair a hernia or place an artificial testicle (testicular prosthesis). [1]
Undescended testicle | Testicular torsion | |
What goes wrong | Testicle stays in the belly or groin | Spermatic cord twists and blocks blood flow |
Timing of surgery | Planned, usually at 6 to 18 months | Immediately, as an emergency |
Main goal | Move the testicle into the scrotum | Untwist the cord and prevent another twist |
If the testicle looks unhealthy | It may be removed and replaced with a prosthesis | It's likely removed and may be replaced with a prosthesis |
Source: [1]
When should orchiopexy be done?
Orchiopexy for an undescended testicle is recommended between 6 and 18 months of age if the testicle hasn't come down on its own by about 6 months. [1]
Testicular torsion is different. It's treated right away, because if blood flow doesn't return to the testicle within six hours, the surgeon may have to remove it. Sudden, severe testicle pain always needs emergency care. [1]
How do you prepare for orchiopexy?
Preparing for orchiopexy means following your child's care team's fasting and washing instructions closely, which lowers the risk of complications. [1]
Before surgery | Stop giving this |
8 hours | Solid food |
6 hours | Formula or cow's milk |
4 hours | Breast milk |
2 hours | Clear liquids, such as water or juice |
Source: [1]
Wash well. Clean your child's belly and groin thoroughly the day before and the morning of surgery. [1]
Daily medicines are usually fine. Your child can take regular medicines on surgery day unless the provider says otherwise. [1]
List every medicine. Tell the team about all prescription and over-the-counter medicines and herbal supplements. Aspirin, anti-inflammatory drugs, and some herbal supplements can raise the risk of bleeding. [1]
With testicular torsion, surgery happens right away, so there may be no time to prepare. Still tell the team about every medicine you take. [1]
New to surgery and sedation? Our guide to anesthesia types, safety, and recovery explains what happens.
What happens during orchiopexy?
Orchiopexy for an undescended testicle is done under general anesthesia by a children's surgical team: a pediatric surgeon or pediatric urologist, a pediatric anesthesiologist, and a pediatric nurse. [1]
Surgery for an undescended testicle
Your child receives general anesthesia, so they're asleep, still, and pain-free.
The surgeon makes a small cut in the groin or scrotum.
They find the undescended testicle and its spermatic cord.
They examine the testicle. If it looks unhealthy, it may be removed and replaced with a prosthesis.
Any hernia is repaired. See our guide to inguinal hernia in babies and children.
A small cut in the scrotum creates a pocket (dartos pouch) to hold the testicle.
The testicle is gently brought down into the pocket.
It's secured with dissolving stitches.
All cuts are closed and covered with glue, gauze, or bandages. [1]
Surgery for testicular torsion
The surgeon makes a cut in the scrotum.
They untwist the spermatic cord and examine the testicle.
A healthy testicle is stitched to the scrotum so it can't twist again.
An unhealthy testicle is likely removed and may be replaced with a prosthesis.
The cut is closed with dissolving stitches and covered with glue, gauze, or bandages. [1]
How long does orchiopexy take?
Orchiopexy takes about an hour in most cases. Afterward, the patient is monitored in a recovery room and usually goes home about two hours later, because orchiopexy is an outpatient procedure. [1]
What are the benefits of orchiopexy?
The main benefits of orchiopexy are protecting future fertility, making testicular cancer checks easier, and lowering the risk of injury. [1]
Health benefits. Orchiopexy may help prevent infertility. It also makes it possible to check yourself for testicular cancer later in life. Read more about male infertility and testicular cancer self-exams. [1]
Lower injury risk. A testicle in the groin is more likely to be injured than one in the scrotum, for example by sports, seat belts, or tight clothing. See our guide to testicular trauma. [1]
Safety. Orchiopexy is a relatively safe procedure with a low risk of complications, and most people go home the same day. [1]
What are the risks of orchiopexy?
The risks of orchiopexy are those of most surgeries, and serious problems are uncommon. [1]
Risk | What it means |
Anesthesia reaction | A response to the medicines used for sleep during surgery |
Infection | Germs entering the incision site |
Hematoma | A collection of clotted blood under the skin |
Swelling and bruising | Common around the groin and scrotum after surgery |
Scarring | A small scar where the cuts were made |
Reascending testicle (rare) | The testicle moves back up out of the scrotum and needs another surgery |
Source: [1]
What is recovery like after orchiopexy?
Recovery after orchiopexy is usually quick: most children return to normal daily activities in two to three days, with pain or discomfort lasting a few days to a week. [1]
Feeling tired is common, and your child may sleep more for a few days. Nausea or vomiting from the anesthesia can last about a day. [1]
When | What to expect |
Surgery day | Home about 2 hours after surgery |
First 24 hours | Clear liquids and bland, soft foods; possible nausea |
Days 2 to 3 | Most adults and children over 1 year resume normal activities |
Days 3 to 5 | Most children return to school or daycare |
Up to 1 week | Pain and discomfort ease |
About 2 weeks | Stitches dissolve; follow-up visit; sports may be cleared |
2 to 3 months | A second follow-up may be needed |
Source: [1]
Avoid sports and rough play for at least two weeks. That includes tumbling, jumping, sprinting, and straddle toys such as a rocking horse, seesaw, swing, bicycle, or tricycle. Always check with your child's provider before restarting these activities. [1]
Every child heals differently, so recovery times can vary. [1]
How do you care for a child after orchiopexy?
Caring for a child after orchiopexy focuses on pain control, cold packs, light eating, and keeping the incisions clean. [1]
Pain relief. Acetaminophen or ibuprofen may be recommended. Always check with your child's provider before giving any pain medicine. [1]
Ice packs. Apply an ice pack wrapped in a light towel for 10 to 30 minutes, four times a day, to ease bruising, swelling, and pain. [1]
Light eating. For the first 24 hours, stick to clear liquids (water, broth, sports drinks) and bland, soft foods (applesauce, bananas, rice, toast). [1]
Clean hands, clean wounds. Wash your hands with soap and water before touching bandages or incisions. [1]
Bathing. Showers or sponge baths are fine. Ask when a full bath or shower is allowed; some children can bathe the next day, while others need to wait a week. [1]
After orchiopexy as an adult (for example, for torsion), follow the same care steps. Don't drive for a week or two, and ask your provider when it's safe to have sex. [1]
When should you call a doctor after orchiopexy?
Call your healthcare provider right away after orchiopexy if you notice any of these warning signs: [1]
Heavy bleeding, pus, or a foul smell from an incision
Fever
Pain that gets worse or isn't controlled by over-the-counter medicine
Swelling
Book a follow-up visit with the pediatrician or surgeon two weeks after surgery. A second visit may be needed two to three months later. [1]
Conclusion
Orchiopexy is a short, common operation that places a testicle where it belongs and keeps it there. For an undescended testicle, it's planned between 6 and 18 months of age. For testicular torsion, it's an emergency that can save the testicle. Most children are home the same day and back to their routine within a few days. [1]
Your next step: If your baby's testicle hasn't dropped by 6 months, or your child has sudden scrotal pain, contact a doctor now. Then keep learning with our guides to how the testicles work and hydrocele in boys. Bookmark this page and share it with anyone helping care for your child after surgery.
FAQ
What is orchiopexy?
Orchiopexy is surgery that moves a testicle into the scrotum and stitches it in place. It treats undescended testicles and testicular torsion. [1]
What is the best age for orchiopexy?
Orchiopexy for an undescended testicle is recommended between 6 and 18 months of age. Surgery is advised if the testicle hasn't come down on its own by about 6 months. [1]
Is orchiopexy a major surgery?
Orchiopexy is a relatively safe outpatient surgery with a low risk of complications. It takes about an hour, and most patients go home the same day. [1]
How long does orchiopexy recovery take?
Orchiopexy recovery takes a few days for daily activities and about two weeks for sports. Most children resume normal activities in two to three days, and stitches dissolve in about two weeks. [1]
When can my child go back to school after orchiopexy?
Most children go back to school or daycare three to five days after orchiopexy. Sports and straddle toys should wait at least two weeks. [1]
Can the testicle move back up after orchiopexy?
A testicle rarely moves back up out of the scrotum after orchiopexy. If this happens, another surgery is needed. [1]
Does orchiopexy help with fertility?
Orchiopexy may help prevent infertility. Research suggests testicular growth and fertility potential improve when surgery is done before one year of age. [1][2]
What are the warning signs after orchiopexy?
Warning signs after orchiopexy include heavy bleeding, pus or a foul smell at the incision, fever, worsening pain, and swelling. Call a healthcare provider right away if any of these appear. [1]
Can an undescended testicle come down on its own?
Yes, it often comes down by itself in the first few months of life. If it has not come down by about 6 months, it rarely does, and surgery is usually advised.
Is orchiopexy done with laparoscopy?
Most orchiopexies use a small cut in the groin or scrotum. If the testicle sits high inside the belly, the surgeon may use laparoscopy with a small camera.
Related Reading
What Are Undescended Testicles? Causes, Risks, and Treatment explains why testicles fail to descend and how this is treated.
Undescended Testicle in Babies: Causes, Timing, and Treatment Explained (2026 Guide) covers when to expect descent in babies and when surgery is needed.
Testicular Torsion: Symptoms, Causes, Diagnosis and Treatment — What You Need to Know explains the emergency signs of a twisted testicle and its treatment.
Inguinal Hernia in Babies and Children: Symptoms, Causes, and Surgical Repair explains groin hernias in children, which often occur alongside undescended testicles.
References
Cleveland Clinic. Orchiopexy. Cleveland Clinic. Last updated January 13, 2025. https://my.clevelandclinic.org/health/treatments/17297-orchiopexy
Gates RL, Shelton J, Diefenbach KA, et al. Management of the undescended testis in children: An American Pediatric Surgical Association Outcomes and Evidence Based Practice Committee Systematic Review. J Pediatr Surg. 2022;57(7):1293-1308. PMID 35151498. https://doi.org/10.1016/j.jpedsurg.2022.01.003
Kaushal S, Varvaris KL, Khondker A, et al. Timing of orchidopexy and effect on surrogate outcomes for fertility: a systematic review and meta-analysis. Pediatr Surg Int. 2026;42(1):40. PMID 41396320. https://doi.org/10.1007/s00383-025-06268-4
Fung ACH, Tsang JTW, Leung L, et al. Comparative Outcomes of Single-Stage versus Two-Stage Laparoscopic Fowler-Stephens Orchidopexy: A Systematic Review and Meta-Analysis. Eur J Pediatr Surg. 2025;35(1):28-35. PMID 39079708. https://doi.org/10.1055/a-2375-9784
Medical disclaimer
This article is for general education and does not replace advice from a qualified healthcare professional. Always follow the instructions of your child's surgeon or care team. If you or your child has sudden, severe testicle or scrotal pain, seek emergency care immediately.
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