What is Pediatric Pelvic & Genital Surgery?

Pediatric pelvic and genital surgery addresses congenital abnormalities, developmental conditions, and acquired problems affecting the genitourinary system in children. These procedures are performed to correct anatomical differences present at birth, treat urgent conditions like testicular torsion, or address issues that become apparent as children grow. Our fellowship-trained pediatric surgeons at Western Surgical Group provide expert, sensitive care for these conditions with attention to both immediate surgical needs and long-term developmental outcomes.

We understand that conditions affecting the genital area can be particularly sensitive for families to discuss. Our team creates a comfortable, supportive environment where parents feel safe asking questions and children receive age-appropriate care. We work closely with pediatric urologists, endocrinologists, and other specialists when comprehensive evaluation and coordinated care are needed.

Many pediatric pelvic and genital procedures can be performed using minimally invasive techniques, resulting in smaller incisions, less discomfort, and faster recovery. Our surgeons have specialized training in pediatric anatomy and surgical techniques that preserve function and consider future growth and development, including fertility preservation when relevant.

Conditions We Treat

Undescended Testes (Cryptorchidism): One or both testicles fail to descend into the scrotum before birth. Surgical correction (orchiopexy) is typically performed between 6-18 months of age to prevent fertility problems, reduce cancer risk, and avoid testicular torsion. This is one of the most common pediatric surgical procedures.

Testicular Torsion: A surgical emergency where the testicle twists on its blood supply, cutting off circulation. This causes severe pain and requires emergency surgery within 6-8 hours to save the testicle. We perform detorsion (untwisting) and fixation to prevent recurrence, typically fixing the other side as well since the condition can affect either testicle.

Inguinal Hernias: A common condition where abdominal contents protrude through a weakness in the groin area. Unlike umbilical hernias which often close spontaneously, inguinal hernias require surgical repair to prevent incarceration (becoming stuck), which can compromise blood supply to trapped tissue. We typically perform these repairs laparoscopically as outpatient procedures.

Hydroceles: Fluid accumulation around the testicle causing scrotal swelling. Congenital hydroceles in infants often resolve spontaneously by age 1-2. Persistent or symptomatic hydroceles require surgical correction to drain the fluid and prevent recurrence.

Ovarian Cysts and Masses: Abnormal growths in the ovaries that may be discovered through imaging or symptoms like pain. Most ovarian cysts in children are benign, but persistent, large, or symptomatic cysts may require surgical evaluation and possible removal. We use minimally invasive techniques whenever possible to preserve ovarian tissue and fertility.

Disorders of Sexual Differentiation (DSD): Rare conditions where reproductive or sexual anatomy doesn’t develop typically. These complex cases require multidisciplinary evaluation involving pediatric surgery, pediatric urology, pediatric endocrinology, genetics, and psychology. Surgical management is highly individualized and decided in partnership with families, focusing on function, long-term health, and the child’s best interests.

Circumcision: Surgical removal of the foreskin, performed for medical indications such as recurrent infections, phimosis (inability to retract foreskin), or balanitis. We also perform delayed circumcision for older infants and children when needed.

Our Approach to Sensitive Care

  • Confidential, judgment-free consultations
  • Age-appropriate communication with children
  • Coordination with pediatric specialists when needed
  • Minimally invasive techniques to minimize scarring
  • Attention to long-term outcomes including fertility
  • Family-centered decision making

What to Expect

Evaluation for pediatric pelvic and genital conditions typically begins with a physical examination and discussion of symptoms or concerns. Additional studies may include ultrasound to visualize internal structures or laboratory testing as appropriate. We take time to explain findings in clear terms and discuss treatment options, timing considerations, and expected outcomes.

Most pelvic and genital procedures are performed as outpatient surgery, meaning your child goes home the same day. Recovery is typically quick, with most children returning to school within a few days to a week. We provide specific post-operative care instructions including pain management, bathing restrictions, and activity limitations. Follow-up appointments ensure proper healing and allow us to address any concerns.

For conditions like undescended testes, we emphasize the importance of timely treatment during the optimal age window. For emergencies like testicular torsion, we prioritize immediate surgical intervention to maximize the chance of saving the affected testicle.

Divisions Involved in Your Care

Diagnoses We Treat

Frequently Asked Questions

Current guidelines recommend surgical correction between 6-18 months of age. While testicles may descend spontaneously in the first few months of life, those that remain undescended by 6 months are unlikely to come down on their own. Early surgical correction (orchiopexy) optimizes fertility potential, reduces cancer risk, makes testicular examination easier, and decreases torsion risk. Delaying beyond 18 months may compromise fertility outcomes.

Testicular torsion is a true surgical emergency requiring treatment within 6-8 hours of symptom onset for the best chance of saving the testicle. The longer the testicle is twisted without blood flow, the higher the risk of permanent damage. If your child experiences sudden, severe testicular or groin pain, go immediately to the emergency room. Every minute counts in preserving testicular function and fertility.

While not always an immediate emergency, inguinal hernias in children should be repaired relatively promptly (typically within weeks to a few months of diagnosis) because they carry a risk of incarceration—where intestine or ovary becomes trapped and cannot be pushed back in. Incarceration can cut off blood supply and become a surgical emergency. If a hernia becomes painful, firm, or discolored, or your child is vomiting, seek immediate medical attention.

Our surgical techniques are specifically designed to preserve fertility whenever possible. For undescended testes, early correction actually protects fertility by preventing heat damage to sperm-producing cells. For ovarian surgery, we use tissue-sparing techniques to preserve as much healthy ovarian tissue as possible. For testicular torsion, prompt treatment maximizes the chance of saving the testicle. We're happy to discuss fertility considerations for your child's specific condition.

Use age-appropriate, honest language. For young children, simple explanations like "the doctor will help move your testicle to where it should be" or "we're fixing a problem so your body works better" are sufficient. Older children and teens may want more detailed information. We're here to help—our team can provide guidance on talking with your child and will use age-appropriate terms during consultations. It's important children understand the surgery is to help them, not a punishment.

Most children recover quickly from these procedures with minimal discomfort managed by over-the-counter or prescription pain medication. Activity is typically limited for 1-2 weeks to allow healing—no rough play, bike riding, or straddle toys during this time. Most children return to school within 3-5 days. Bathing restrictions apply for the first few days. We schedule follow-up appointments to check healing and remove any external sutures if needed, though we often use dissolvable sutures.