If you've been diagnosed with testicular cancer, your doctor has probably talked to you about orchiectomy, surgery to remove one or both testicles. Testicles, or testes, are the male sex organs that make sperm and the hormone testosterone.
Why Get Orchiectomy?
It's usually needed to treat testicular cancer. But it can also help if a testicle is damaged by infection or injury. Sometimes it's part of prostate cancer treatment.
If doctors suspect testicular cancer, they will likely order an ultrasound test first to check for non-cancer causes. Blood tests may also be ordered to help diagnose testicular cancer.
Rather than doing a biopsy of the testes, which can trigger cancer spread, doctors almost always do what’s called a radical inguinal orchiectomy. It's called "radical" because it removes the spermatic cord along with the testicle and tumor. The cord has blood and lymph vessels that could let the cancer spread to other parts of the body.
In a simple orchiectomy, the doctor only removes one or both testicles. This surgery can ease symptoms, prevent problems from prostate cancer, and treat male breast cancer.
What to Expect
In a radical inguinal orchiectomy, your surgeon will make a small cut just above your pubic area. They’ll push your testicle up and remove it through that opening.
The surgery won’t affect your penis or scrotum, the sac that covers your testicles.
The surgery usually takes about an hour. The doctor will close the cut with staples or stitches. They’ll take them out a week or so later. You may go home the day of your surgery, or you might have a short hospital stay.
These dos and don’ts after surgery will help you heal:
- Keep an ice pack or cold compress on your scrotum to ease swelling. It should get better in a few days. Don't keep the ice on for more than 15 minutes at a time.
- Your surgeon probably will suggest you wear a jockstrap or snug underwear for a few days to help with swelling, too.
- Take pain medicine as prescribed. Don't drive until you've stopped taking medicine and your doctor says it's OK.
- Your doctor will tell you when you can shower. You'll have to skip baths and swimming until the cut made during surgery heals.
- The doctor will show you how to take care of your cut. Check it every day for signs of infection or other problems.
- Take it easy for a few days after surgery. Don't lift anything heavy, have sex, or do hard exercise for a few weeks. Follow the directions you get from your doctor.
- If you had surgery due to cancer, you may have to have chemotherapy or radiation to lower the chances that any leftover cancer cells will spread.
Life After Surgery
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.