By Treezer Michelle 

Judith Nanjala, a resident of Bungoma County and a mother of two says it took her a year to realize that her second born child had undescended (improperly positioned) testicles. It was in one of her many visits to the hospital that the doctor noticed that the boy’s testicles were not in their correct position (in the scrotum).

Luckily for Judith, the discovery was on time as the condition could still be corrected. “We were able to raise the money needed for the surgery from friends and family. The surgery took so long I almost panicked. My son is fine now,” says Judith.

An undescended testicle is a testicle that hasn’t moved into the bag of skin below the penis (scrotum) before birth. The condition is rare in full term babies but common in baby boys born prematurely. Also known as cryptorchidism, undescended testicle is the most common disorder of sexual differentiation in boys.

According to Kenya Demographic and Health Survey, in every 32 live births of boys in Kenya, one is born with undescended testicle. Of the total number of boys affected, 29% are boys born prematurely. This data does not include the other babies that were not delivered in the hospital.

Orchiopexy is a simple surgery done in all major hospitals in the country to correct this condition. It is a surgery to move an undescended testicle into the scrotum and permanently fix it there.

According to Dr. Dickens Lubanga, the Chief Pediatrician at Bungoma Referral Hospital, the rate of success of orchiopexy is very high. All the six orchiopexy surgeries done this year, only one was unsuccessful, he says, attributing the failure to late discovery and late surgery.

Dr. Dickens Lubanga

The surgery should be done early in childhood between 6-9 months to prevent future complications like infertility and testicular cancer. The latest it should be carried out is at 18 months.

Orchiopexy procedure can either be done with a laparoscope (a small tube containing a camera is inserted through a small incision in the child’s abdomen) or with an open surgery. Laparoscopy is done to locate the testicle in the abdomen. The doctor may be able to correct the condition during this procedure but in most cases, an open surgery follows.

In an open surgery, a larger incision in the groin near the testicle is made and the testicle to be repaired is located. The testicle is examined and then placed into the scrotum.

According to Dr. Joseph Kipsang’, a pediatric surgeon at Bungoma Referral Hospital, orchiopexy is a minor surgery and the healing takes just one month except in cases where the surgery is done in two stages.

Orchiopexy is done in two stages if in the first stage of the surgery, spermatic chord (a collection of vessels, nerves and ducts that run to and from the testicles) is accidentally severed leading to non-visibility of the testis.

Dr. Kipsang’  notes that the surgery has a proven success of 99% with few failed cases being as a result of the surgeries not being done in time.

Orchiopexy surgeries are rare, he says, noting that Bungoma County Referral Hospital conducts about 7 such surgeries in a year.

Dorcas Nakhumicha is a mother of one and a resident of Kimilili Sub-County in Bungoma County. Dorcas has a 10 month old son who underwent Orchiopexy when he was 7 months old. The healing process according to Dorcas was fast and she is happy that the surgery was successful.

“I was worried that my son would develop complications after the surgery but the doctor assured me that he would be fine,” she said.

Orchiopexy may be a solution to undescended testicle but it has its challenges. The surgery is very expensive since it goes for a minimum amount of ksh 100,000.

“The Orchiopexy surgeries at Bungoma Referral Hospital are not part of free medical care. Parents have to make payments before the surgery is performed on their children,” said Dr. Kipsang’.

He added that the surgery has several other challenges which include blood clot in the scrotum.

“Blood clots between the layers of the sac that surrounds each testicle. The clot causes pain and discomfort later to the child. In some cases, the body is able to reabsorb the blood. If not, the child will need another surgery to remove the clot,” he said.

Dr.Kipsang’ also adds that Orchiopexy surgery can also cause blood clot in the testis. If this happens, the clots prevent adequate blood flow to the testis causing it to shrink. This can result to decreased sexual drive after puberty.

“The surgery can also cause an infection called Epididymo-orchitis, an inflammation of the testis. A course of antibiotic medicine will usually clear the infection,” he said.