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Orchiectomy

What’s an orchiectomy?

An orchiectomy is a surgical procedure done to remove one or both of your testicles. It’s normally done to treat or prevent prostate cancer from spreading.

An orchiectomy can help treat or prevent testicular cancer and breast cancer in men. It’s also usually done before sexual reassignment surgery (SRS) if you’re a transgender woman making the transition from male to female.

Types of orchiectomy

There are various types of orchiectomy procedures depending on your condition or the goal that you’re trying to achieve by having this surgical procedure done.

Simple orchiectomy

One or both testicles is taken out through a small cut in your scrotum. This may be performed to treat breast cancer or prostate cancer if your doctor wants to limit the amount of testosterone that your body makes.

Radical inguinal orchiectomy

Here, one or both testicles is removed through a small cut in the lower part of your abdominal area instead of your scrotum. This may be performed if you’ve found a lump in your testicle and your doctor wants to test your testicular tissue for cancer. Doctors may prefer to test for cancer using this surgical procedure because a regular tissue sample or biopsy can make cancer cells more likely to spread. This type of surgical procedure may also be a good option for a transition from male to female.

Subcapsular orchiectomy

The tissues around the testicles are removed from the scrotum. This lets you keep your scrotum intact so that there’s no outward sign that anything has been taken out.

Bilateral orchiectomy

In bilateral orchiectomy, both testicles are removed. This may be performed if you have prostate cancer, breast cancer or are transitioning from male to female.

Who’s a good candidate for the orchiectomy procedure?

Your doctor may do this surgical operation to treat breast cancer or prostate cancer. Without the testicles, your body can’t make as much testosterone. Testosterone is a hormone that can cause prostate or breast cancer to spread faster. Without testosterone, the cancer may grow at a slower rate and some symptoms like bone pain may be more manageable.

Your doctor may recommend orchiectomy if you’re in good health and if the cancer cells have not spread beyond your testicles or far beyond your prostate gland. You may want to do an orchiectomy if you’re transitioning from male to female and want to limit the testosterone your body makes.

How effective is this orchiectomy procedure?

This surgical procedure effectively treats prostate and breast cancer. You can try hormone therapies with antiandrogens before considering an orchiectomy, but these can have side effects like:

Damage to your thyroid gland, liver or kidneys.

Blood clots.

Allergic reactions.

Preparation for this orchiectomy procedure

Before an orchiectomy, your doctor may take blood samples to ensure you’re healthy enough for surgical procedure and to test for any indicators of cancer.

This is an outpatient procedure that takes 30-60 minutes. Your doctor may use either local anesthesia or general anesthesia to numb the area. General anesthesia has more risks but allows you to remain unconscious during the surgery.

Before the appointment, ensure that you have a ride home. Take a few days off work and be ready to limit your amount of physical activity after the surgical procedure. Tell your doctor about any medications or dietary supplements that you’re taking.

How is the orchiectomy procedure done?

First, your doctor will lift your penis and tape it to your abdomen. Then, they’ll make a cut either on your scrotum or the area right above your pubic bone. One or both testicles are then cut out from nearby tissues and vessels and removed through the incision.

Your surgeon will use clamps to prevent your spermatic cords from gushing blood. They may put in a prosthetic testicle to replace the one that’s been taken out. Then, they’ll wash the area with a saline solution and sew the cut shut.

Recovery from orchiectomy

You should be able to go home some hours after an orchiectomy. You’ll need to return the next day for a checkup.

For the first week after an orchiectomy:

Wear a scrotal support for the first 48 hours after the surgical procedure if instructed to by your doctor.
Use ice to limit swelling in your scrotum or around the incision.
Wash the area with a mild soap when you bathe.
Keep your incision site dry and covered in gauze for the first few days.
Use any creams or ointments following your doctor’s instructions.
Take non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen for your pain.
Avoid straining during bowel movements. Take lots of water and eat high-fiber foods to keep bowel movements regular. You can also take a stool softener.

It can take up to 2 weeks to 2 months to fully recover from an orchiectomy. Don’t lift anything over ten pounds for the first two weeks or have sexual intercourse until the incision has fully healed. Avoid exercise, sports and running for four weeks after the surgical procedure.

Are there any side effects or complications of orchiectomy?

See your doctor immediately if you notice any of these side effects:

Pain or redness around the incision.
Pus or bleeding from the incision.
Fever over 100°F (37.8°C)
Inability to urinate.
Hematoma, which is blood in the scrotum and normally looks like a large purple spot.
Loss of feeling around your scrotum.

Outlook

An orchiectomy is an outpatient surgical procedure that doesn’t take long to fully recover from. It’s less risky than hormone therapy for the treatment of prostate or testicular cancer.

Be open with your doctor if you’re getting this surgical procedure as part of your transition from male to female. Your doctor may be able to work with you to reduce scar tissue in the area so that future sexual reassignment surgery may be more successful.

Disclaimer: The information provided herein is for patient general knowledge only and should not be used during any medical emergency, diagnosis or treatment of any medical condition. Duplication for personal and commercial use must be authorized in writing by Surjen.com.