Undescended testes (cryptorchidism) are increasingly common in baby boys. If they don’t descend, the ‘cure’ is surgery, and the operation is called an orchidopexy. I’ve put together a separate page on the treatment of undescended testicles, but if you want a quick look at what is done, this YouTube video shows roughly the procedure performed on me (on the opposite side).
I was nearly 3 ½ when I had surgery in the late 1980’s at the Queen Elizabeth Medical Centre Nottingham (QMH) to correct an acquired undescended testicle. It’s the most memorable day of my life – for all the wrong reasons.
I was born with both testicles undescended, both of which descended before my first birthday and were confirmed as descended at hospital.
At my second year checkup the GP recorded that “both testes are just palpable at the external ring but do not descend into the scrotum, even on squatting down”. He referred me to hospital.
The consultant found whether I was standing, crouching or sitting, the testes were not in the scrutum, but if I lay down my testicles could be coaxed into the scrotum and were a normal size. She opted to wait 6 months and if they weren’t lying easily int he scrotum, she’d refer me for ochiodopexy.
I was taken back six months later for a checkup, and the right testis came “well down” the scrotum, but the left testis only came into the upper half of the scrotum.
Six months later aged 3 1/4, the right testicle came mid-way down the scrotum and the left testicle could no longer be pulled further than the very top of the scrotum.
I was scheduled for surgery.
That’s all very clinical, very medical. But what’s it like for the child? For the human story, read on…
What I remember before the surgery
I was a happy and healthy child, and my favourite toy at this time was my sandpit.
I remember us visiting the hospital once, maybe twice – the time before the surgery is blurred – to see an Indian lady (she was the consultant). I didn’t know why we were there, and vividly remember being on an examination table and being examined lying down and then on all fours by her, and her squeezing my scrotum from behind.
I didn’t understand why she was touching me, why mummy and daddy had brought me here. It wasn’t unpleasant being touched, but I didn’t want to be.
There was a nurse sat in the room too. She sat to the side of the examination table and watched everything. Even aged 3 I didn’t want someone staring, and felt it ‘wrong’.
I remember crying as the consultant squeezed my scrotum. The next,vivid memory is sitting on the floor playing with a wooden carousel with red, blue and yellow painted horses while the consultant talked to my parents. Needless to say I thought that was it and the worst was behind me…
There were two other appointments with different doctors (both men), one before and one after the one I remember.
I now know the hospital was a teaching hospital and quite progressive for the time. We had a tour of the hospital beforehand with other parents and children, I was given a toy medical set and a paper gown, hat and mask to play with.
Other boys at nursery were being ‘done’ (operated on) about the same time, and I remember clearly one boy who had his undescended testicle surgery about a month before me (I can recall his face & us playing together, but not his name). My mum told me to ask him about it, but I never did. I didn’t know how, and even then I was embarrassed and knew it wasn’t something we talked about. I was aware people were talking about me: I knew the ladies at playschool were talking about me in the corner with my mum.
It turned out (to my parents’ disappointment) the nice lady consultant wasn’t the one who was going to do my surgery – she only did difficult cases. My surgeon was a man who was later described as “horrid” and having “absolutely no bedside manner” to me.
Late one afternoon Daddy took me to the hospital and I had to take my trousers and pants off and lie on my back in the frog position while two men examined my groin. One of them had a mustache The room was dark with a very bright light above my groin, and Dad stood behind them.
With a pen they drew a question mark on my right thigh (not until I was anesthetized would they decided this testicle was retractile and didn’t need surgery), and something on my left thigh (an arrow? A cross? – I don’t remember) to mark it was undescended and needed operating on. I enjoyed being centre of attention but had no inkling of what was coming next…
I vaguely remember leaving home the next morning, and Mum holding me tight and looking very upset, and Dad taking me for a drive in our car.
I was admitted for a left orchidopexy and a possible right orchidopexy.
At some point they put a clear plastic patch on the back of my left hand filled with cream (numbing cream) which was a source of fascination for ages afterwards.
The next bit I remember so clearly it’s like watching a movie: a bearded man in a white coat is in our room (Dad was staying with me in hospital and we had our own room) giving me something horribly sweet to drink. Then I woozily recall Dad getting me changed into a gown, while he put on these pyjamas made of a shiny dark green material. The last I properly remember is Daddy telling me I needed to have a wee, but I don’t remember doing it…
And that’s where my memories should stop. Yet now there’s a scary, horrible period of hazy memories, sensations and thoughts. I blurrily sense bright lights moving past overhead. I semi-recall noises and a woman’s hands grabbing me. (I later found out I got off the trolly on the way to the operating theatre and tried to run away).
There’s more bright lights and inhuman figures without faces clustered round my torso. Authoritative, cross voices. I didn’t know what was going on, I felt terrified and was completely powerless. I wanted to scream; why was Daddy letting this happen? I wanted to move but was unable to. I feel hands on me, holding me down. And background sounds: voices, the clink of items (bottles? metal against metal?).
Everything goes black.
And there my memories of my operation should stop.
But they don’t. There’s a gap, then I sense a shining, bright, warm orb coming towards me from above my head, and hovering below me. I am totally relaxed. I don’t see anything, only light and dark. I feel sensations of pressure on my inside left thigh, an awareness that my legs are apart. Gentle pressure on my left groin. Sounds of people moving around, of clinking, metal on metal. Indistinct voices.
And then nothing.
I will never know when (or if) I woke up during the operation (intraoperative awareness, as they call it). It could’ve been shortly after being transferred to the operating table, or near the end. Or the recovery room, which I’m entirely amnesiac about. It’s over 30 years ago and the memories have gradually appeared with time. Plus – how does a 3 year old make sense of it? What I do remember is:
- Fingers or something largeish in my mouth
- Touch on my left thigh
- Tugging, pulling and pressure on (inside?) my left groin, a sensation I’ve never felt since so is hard to describe
- The touch of latex gloves
- Sounds of voices and machines
- I can’t move
- Thankfully, no pain
I could have invented all these memories. I had nothing other than an absolute terror of all things medical from the age of 5 onwards. Aged 8 or 9 I made some wildly uneducated guesses about what happened and it was only later in life thanks to the internet that I could learn what would have been going on and imagine myself back in it.
Sometimes I berate myself that I’ve made it all up to torture myself. Then I think of the fear that runs so deep and decide that even if I’ve invented what happened to fill the gap in my memory, something did happen. It upset and scared me enough to scar me for the following 30+ years.
The surgeon made an incision on the left side and found a hernia sac which he fixed, freed the testicle, put it in a Dartos pouch and stitched it with 4/0 nylon to the scrotum.
He spent time checking the right testis, and confirmed it could be brought to the base of the scrotum but was retractile.
I next remember is waking up with orange light streaming through the drawn curtains. Daddy and a nurse were sitting to the left of the bed. I don’t think it was our room.
I had so much to say, so many dreams full of creatures to describe.
I felt euphoric. I was talking nineteen to the dozen and Daddy told me to be quiet and go back to sleep.
I don’t then remember anything until breakfast the next day (we stayed in the hospital overnight), which we went and ate in a brightly painted area at a small table which was too low for Dad but just right for me, and I was allowed white toast which was a treat. There’s photos of the time I’m asleep/sitting up in bed half-asleep in the family photo album (what kind of family commemorates this experience???) – Dad apparently nipped home to get his camera while I was in the operating theatre.
While the undescended testicle surgery was successful by any medical measure, its psychological effects on me – especially of remembering bits around the surgery and slowly recalling more – weren’t kind, and shaped the next three decades of my life. Continue reading the complications later in life in Life after undescended testicle surgery.