Radical inguinal orchiectomy for testicular cancer

Surgery Overview

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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.

During the procedure, a small incision is made in the lower abdomen just below the belt line. The testicle is then pushed up from the scrotum through the incision and removed. The procedure is usually finished in less than an hour.

What To Expect After Surgery

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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

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Orchiectomy is always performed 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 necessary, though this is rare.

How Well It Works

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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 adjuvant therapies such as chemotherapy or radiation therapy.

In some cases of early-stage testicular cancer, orchiectomy is the only treatment necessary and is followed only with a watchful waiting program. Watchful waiting, or surveillance, is a period of time during which you and your health professional observe your symptoms or condition 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

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

• Reactions to anesthesia or medications.
• 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

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In the majority of 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.

Complete the surgery information form (PDF) (What is a PDF document?) to help you prepare for this surgery.

Credits

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Author	Kathe Gallagher, MSW
Editor	Alison Allen
Editor	Kathleen M. Ariss, MS
Associate Editor	Pat Truman, MATC
Primary Medical Reviewer	Martin Gabica, MD - Family Medicine
Primary Medical Reviewer	Kathleen Romito, MD - Family Medicine
Specialist Medical Reviewer	Christopher G. Wood, MD, FACS - Urology/Oncology
Last Updated	February 5, 2007