An orchiectomy (also known as an orchidectomy) is surgery to remove one or both of the testicles. There are several types of orchiectomy procedures depending on your condition or the goal that you’re trying to reach by having this procedure done: -Simple orchiectomy - One or both testicles is removed through a small cut in your scrotum. This may be done to treat breast cancer or prostate cancer if your doctor wants to limit the amount of testosterone that your body makes. -Radical inguinal orchiectomy - 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 done 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 surgery because a regular tissue sample, or biopsy, can make cancer cells more likely to spread. This type of surgery 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 allows you to keep your scrotum intact so that there’s no outward sign that anything has been removed. -Bilateral orchiectomy - Both testicles are removed. This may be done if you have prostate cancer, breast cancer, or are transitioning from male to female. https://www.healthline.com/health/mens-health/orchiectomy
An orchiectomy can be perfored in order to treat or prevent testicular cancer and breast cancer in men. It’s also often done before sexual reassignment surgery (SRS) if you’re a transgender woman making the transition from male to female.
-Your doctor may recommend this procedure as a good option to treat certain diseases, such as testicular cancer or metastatic prostate cancer, or severe injury to the testicles.
-You will experience new changes to your life style once your testicle are removed. This may affect your sex life and how you perceive your self to others.
-Surgery comes with complications and side effects as well.
The doctor will make an incision in the lower abdomen just above the crease at the top of the thigh in patients with testicular cancer and an incision will be made in the scrotum directly in patients with prostate cancer. When the testicle is located, the blood vessels feeding into it will be tied off and the testicle will be removed. The incision will then be closed. The procedure takes approximately 45 to 60 minutes and requires one night’s stay at the hospital. Some patients might be able to go home after the procedure.
Your doctor will assess your health to ensure you are ready to undergo the procedure by ordering blood tests, chest x-ray, and electrocardiogram (EKG) and checking your tumor markers. You will be asked to avoid food and water for at least six to eight hours before the procedure. You will be given other instructions as well, including information regarding an artificial testicle.
You may feel some dizziness after the procedure so it is recommended that someone take you home. Pain at the surgical site will be managed with pain medication. You should get up and walk around as soon as you are able to help promote healing and reduce complications. Wear supportive underwear for one to two weeks after the procedure. You will receive instructions regarding caring for the incision. A dressing is usually placed for two days, after which you can remove it yourself. Sutures are normally dissolvable and do not need to be removed. You may return to work after one to two weeks, but avoid lifting heavy objects. Please wait one week before driving. You may return to more strenuous activities and exercising after four to six weeks. You may have sexual intercourse as you are comfortable; there are no specific timelines for it.
Bleeding that may require additional surgery (rare). Infection. Numbness at the surgical site, which is temporary. Hernia if the patient returns to driving or lifts heavy objects before the specified time. If both testicles were removed, no testosterone will be produced. (Even if one testicle is removed, sometimes that can affect how much testosterone is produced.) Reduced sex drive. If the surgery is performed before puberty, it can affect the patient’s development. (The patient’s voice may not change and hair may not grow under the arms and around the penis.) - Swelling or bruising at the surgical site or the scrotum. - If you experience any of the following signs of infection, come back and see your doctor immediately: - Swelling and redness. - Numbness. - Throbbing pain. - Fever. - Discharge from the incision.
What are the recommendations for travel for this procedure?
If you are taking any blood-thinning medication/anticoagulant, please let your doctor know as some may need to be stopped before you travel for the procedure. Travelers to Thailand should plan to stay in the country for at least two to five days after the procedure, depending on their condition after surgery, or for the entire duration of treatment. If you plan to return home after the procedure, please speak to your doctor before making travel arrangements. There are no restrictions for air travel. During your follow-up appointment your medical team will assess your health and your incision and you will receive documents detailing your medical and treatment history and your "Fit to Fly" certificate (if needed).
How effective is this procedure?
This surgery effectively treats prostate and breast cancer. You can try hormone therapies with antiandrogens before considering an orchiectomy, but these can have side effects, including: -damage to your thyroid gland, liver, or kidneys -blood clots -allergic reactions
What will my life be like after this procedure and how will I readjust?
Having one or both testicles removed can change the way you feel about your body. Surgery may affect how you look, your fertility, and your interest in sex. You may be concerned about how you look to a partner or in a locker room. If it’s a problem, you can have surgery to implant an artificial testicle. It's filled with saline and is made to look like the real thing. There will be a small scar, but your pubic hair can help hide it. If you still have one testicle, you should still be able to get an erection and have sex. If both are removed, your body won't be able to make sperm. If you want to have children, you may want to store sperm before the procedure. Talk to your doctor to plan ahead. Without both testicles, your body won't be able to make as much testosterone as it needs. That might lower your sex drive and make it harder to have erections. You could have hot flashes, lose some muscle mass, and be more tired than usual. Talk to your doctor about a testosterone gel, patch, or shot that will help ease these symptoms.