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Orchiectomy for Testicular Cancer

Surgery Overview

Orchiectomy is the removal of one or both testicles (testes). The testicles are the male sex organs that produce sperm and the male hormone, testosterone.

An orchiectomy is a common treatment for testicular cancer. It may also be done to treat other conditions such as prostate cancer or in the event of severe trauma to one or both testes.

When this surgery is done for testicular cancer, it is called a radical inguinal orchiectomy. It is called "radical" because the entire spermatic cord is removed as well as the testicle itself. And it is called "inguinal" because the testicle is removed through a small cut (incision) made in the lower abdomen (groin).

During the procedure, after the cut is made, the testicle is pushed up from the scrotum through the incision and removed. The surgery is usually finished in less than an hour.

What To Expect

Orchiectomy can be done as an outpatient procedure or with a short hospital stay. Regular activities are usually resumed within 1 to 2 weeks. And a full recovery can be expected within 2 to 4 weeks.

Why It Is Done

Orchiectomy is always done when testicular cancer is suspected. This is because testicular lumps are often cancerous and must be removed as part of treatment. Also, performing a biopsy on a testicle before it is surgically removed can cause cancer cells to spread, making successful treatment more difficult.

Sometimes bilateral orchiectomy (removal of both testes) is needed, though this is rare.

How Well It Works

Orchiectomy is the most effective way to remove cancerous tumors of the testicles. In some cases, orchiectomy is followed by additional surgery to remove cancer that has spread or by other therapies such as chemotherapy or radiation therapy.

In some cases of early-stage testicular cancer, orchiectomy is the only treatment needed and is followed only with a surveillance program. Surveillance is a period of time during which your doctor watches you closely with checkups and testing but without using medical treatment.

Testicular cancer is a very curable form of cancer, especially if it is diagnosed and treated at an early stage. Orchiectomy is important to the successful treatment of this disease and offers the best chance for cure.

Risks

Orchiectomy surgery is relatively low-risk, and complications are uncommon. But orchiectomy carries all the risks of any major surgery, including:

  • Reactions to anesthesia or medicines.
  • Infection.
  • Bleeding.

Bilateral orchiectomy (removal of both testes) is rarely done and carries the possibility of side effects. They are related to the loss of testosterone following the removal of both testes. These include:

  • Infertility.
  • Loss of sexual interest.
  • Erection problems.
  • Hot flashes .
  • Breast enlargement (gynecomastia).
  • Weight gain.
  • Loss of muscle mass.
  • Osteoporosis .

What To Think About

In most cases, orchiectomy does not result in long-term sexual side effects or infertility, though it may increase these problems if they were present before the surgery. If a man has one healthy testicle, he should not notice any negative change in his quality of life. Men who do not have one normally functioning testicle after orchiectomy will need to take hormone therapy to fulfill the body's need for testosterone.

Some men choose to have a prosthetic testicle(s). After an orchiectomy, the surgeon places the artificial testicle(s) in the scrotum to maintain the natural appearance of the genitals.

If you have any questions or concerns about this surgery, talk to your doctor.

Credits

ByHealthwise Staff
Primary Medical ReviewerE. Gregory Thompson, MD - Internal Medicine
Kathleen Romito, MD - Family Medicine
Christopher G. Wood, MD, FACS - Urology

Current as ofMarch 28, 2018


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