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) for a transgender woman making the transition from male to female.
Orchidectomy may be performed for the following reasons:
The majority of men with testicular cancer undergo orchidectomy. Complete removal of the affected testicles may improve the chances of recovery.
The hormone testosterone has been shown to promote the growth and spread of prostate cancer cells. Some men with advanced or metastatic prostate cancer elect to have their testicles removed in order to reduce testosterone levels by removing the source.
Each testicle receives blood via the spermatic cord. Torsion of the spermatic cord, which cuts off the blood supply, causes testicular torsion. Torsion of the testis is a medical emergency. If treated quickly, surgery can repair the damaged testicle and restore blood supply. If the testicle cannot be saved, it may be surgically removed.
The testicles are not as well protected as other organs due to their location in the scrotum. As a result, any trauma to the groin area can easily injure them. A man suffering from a severe injury may lose his testicle.
Undescended testicles (cryptorchidism)
The testicles of a male fetus are found in the abdominal cavity during development. In normal circumstances, they descend to the scrotum before he is born. If this does not occur, the child is said to have undescended testicles. It is possible that one or both testicles are not descended. In some cases, the testicles descend on their own before the boy reaches the age of six months. If they haven't descended by then, surgery to move them into the scrotum may be required. If a testicle is malformed or damaged, it may need to be removed.
Transgender women (people who are biologically male but identify as female) may choose to have an orchidectomy as part of their gender transition. During the transition, other surgeries, such as vaginoplasty (surgical creation of a vagina), may be performed.
Types of Orchidectomy
There are various types of orchiectomy procedures depending on the condition or the goal that you’re trying to achieve by having this surgical procedure done.
One or both testicles is taken out through a small cut in your scrotum. This may be performed to treat prostate cancer or breast cancer if your doctor wants to reduce the amount of testosterone that your body makes.
Radical inguinal orchiectomy
One or both testicles are removed through a small cut in the lower abdomen instead of the scrotum. If you noticed a lump in your testicle and your doctor wants to test the testicular tissue for cancer, this procedure may be performed because a regular biopsy or tissue sample can cause cancer cells to spread. This type of surgical procedure may also be appropriate for a male-to-female transition.
This type of surgical procedure may also be appropriate for a male-to-female transition.
The tissues surrounding the testicles are removed from the scrotum. This allows to keep your scrotum intact, so there is no visible evidence that anything has been removed.
In bilateral orchiectomy, both testicles are removed. If you have prostate cancer or are transitioning from male to female, this procedure may be performed.
Before the procedure
- If you are taking medicines that cause blood thinning, your urologist will advise you to stop using them before surgery.
- Your urologist will also suggest you a prosthetic testicle in place of the surgically removed testicle.
- A blood test is performed to identify tumor markers like alpha-fetoprotein, beta-human chorionic gonadotropin, and lactate dehydrogenase. By observing tumor marker levels, your urologist will understand how much cancer has spread into your body.
- A sperm check-up to check your sperm count. If your healthy sperm count is low, your urologist will recommend freezing your sperm before surgery.
- A computed tomography (CT) scan of your pelvis, chest, and abdomen. By viewing the results of your CT scan, your urologist will understand if the cancer has spread to other parts. Before undergoing a CT scan, you should inform your doctor if you have a health condition like asthma or allergic to iodine.
- Inform your doctor about all medications you use, including over-the-counter and prescription medications, herbs, vitamins, and other supplements. It also includes blood thinning medications, such as clopidogrel, or aspirin taken on a daily basis. You may need to discontinue some or all of them prior to surgery.
- Do not eat or drink 8hoursa before your surgery.
- An intravenous line is put into a vein in your arm or hand. This line delivers fluids and medicines.
- General anesthesia will be administered to keep you in a deep sleep-like state and pain-free during the procedure. To help you breathe, a tube may be inserted into your throat.
During the procedure
- First, your surgeon will lift and tape your penis to your abdomen. They'll then make an incision in your scrotum or just above your pubic bone on your lower abdomen. The testicles are then separated from the surrounding blood vessels and tissues and then removed through the incision.
- Clamps will be used by your surgeon to keep your spermatic cords from gushing blood. A prosthetic testicle may be implanted to replace the one that has been removed. The incision will then be sutured after being washed with a saline solution.
After the procedure
You will be taken to the post-anesthesia care unit where you will be closely monitored as you awaken from anesthesia. You may experience sleepiness and nausea. Your throat may be sore at first if a breathing tube was used. An ice pack may be applied to the surgical site. This aids in the reduction of swelling. You may also be advised to wear a jockstrap to reduce pain and swelling while also preventing injury. When you're ready to go home, have someone responsible drive you.
During your recovery:
- Apply an ice pack to the scrotum to reduce swelling. Do this for a maximum of 15 minutes at a time. Continue using the cold pack for three days or until the swelling subsides. To make an ice pack, place ice cubes in a plastic bag with a top seal. Wrap a clean, thin towel or cloth around the bag. Never apply an ice pack or cold compress directly to the skin.
- Take care of your incision as directed. Check the incision for signs of infection on a daily basis.
- Take prescribed pain medicine as directed.
- Don't swim, use a hot tub, bathe, or do other things that may cause the incision to interfere with the water.
- Wear snug underwear or a jockstrap as directed.
- Avoid heavy lifting and strenuous exercise.
Benefits and Risks of Orchiectomy Surgery
Orchidectomy can provide several benefits in certain medical conditions such as prostate cancer, testicular cancer and is also a common part of gender reassignment surgery for transgender women.
Orchiectomy surgery is relatively low-risk, with few complications.
However, orchiectomy carries all of the risks associated with any major surgery, including
- Reactions to anesthetic medications.
Bilateral orchiectomy is rarely done and carries the possibility of side effects. They are associated with testosterone loss following the removal of both testes. These include:
Orchiectomy Surgery Care at Medicover
At Medicover Hospital, we have an expert team of Surgeon to perform orchidectomy and ensure the most accurate and timely treatment procedures for all our patients. We offer top notch facilities, the latest evidence based treatment protocols and advanced technologies which has made us one of the best hospitals in India. We are one of the best orchidectomy procedure specialists to provide best treatments at affordable costs in India.