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The removal of the testicle, or orchidectomy, is associated with considerable mental discomfort for a man, but for he alth reasons, surgery should not be considered when it is indicated. In what cases does the doctor decide to amputate the testicle?

Removal of the testicle( orchidectomy ) or both testicles is most often performed because of a diagnosis of testicular cancer, or even merely suspected cancer. Because also in the latter case, the testicle should be immediately amputated. For example, it is not recommended to perform a biopsy, because this test carries a too high risk of spreading cancer cells in he althy tissues. Especially when it comes to removing only one testicle, the decision should not be difficult for the patient. You can live normally with one. In principle, nothing changes when it comes to the sexual sphere. The absence of one testicle does not impair erectile function, nor does it interfere with the planning of offspring (the male sex hormone testosterone, apart from the testes, is also produced by the adrenal glands). The number of sperm that one he althy testicle can produce is more than enough for fertilization. In addition, if someone is very interested in aesthetics, you can consider the possibility of implanting a silicone implant - a testicle prosthesis. The testicles are removed for other reasons than the tumor.

Indications for orchiectomy

  • testicular cancer at any stage of development and suspected cancer
  • prostate cancer
  • breast cancer
  • testicular trauma, inflammation, testicular torsion
  • sex change operation
  • cryptorchidism

In most cases, surgery is done to reduce testosterone production. For example, prostate cancer or breast cancer have a hormonal background. Their growth and metastasis to other organs is caused by testosterone. Thus, removal of one or both testicles gives very good results in the treatment of these diseases.

Not related to the male sex hormone is orchiectomy in case of testicular torsion or some kind of trauma. However, in principle, the testicle (or both testicles) is prophylactically amputated due to cryptorchidism, i.e. such an anatomical defect in which the testicle does not descend into the scrotum. It stays in the abdominal cavity or in the inguinal canal. This leads to its overheating,which in turn may result in the development of cancer, or a slowdown and weakening of sperm production, and thus - infertility. Usually, however, before the urologist decides to remove such a testicle, an attempt is made to select it into the scrotum - also by surgery.

Testicular amputation

Orchidectomy is a surgical procedure that has several versions, depending on the type and severity of the disease it causes:

  • simple orchidectomy, performed in the event of a testicular trauma, torsion or as a result of descending testicular inflammation. The operation consists in removing only one testicle along with the epididymis, vas deferens and the whitish sheath.
  • radical orchidectomy, i.e. complete removal of the testicle together with the epididymis and seminal cords through access from the abdominal cavity (inguinal canal). Testicular cancer predisposes to this type of surgery. Sometimes both kernels need to be removed, this is called castration.
  • subcapsular orchidectomy, i.e. amputation of the testicle itself. The epididymis, the vas deferens and the whitish sheath are left in the scrotum.

It also happens that in the case of testicular cancer, enucleation and resection of the tumor itself can be used. However, it is an operation that requires high precision and only a very experienced team of doctors can undertake it. There is a risk that the entire tumor will not be cut out.

Preparation and course of the treatment

Before starting the testes removal, the patient should perform the following tests: scrotal ultrasound, ECG, blood group, sodium, potassium and glucose levels in blood serum, coagulation system, HBs, Anti-HCV. Two days in advance, you must not take aspirin or any non-steroidal anti-inflammatory drugs. You must also fast for eight hours, not even drink.

The patient is placed in the supine position for the orchidectomy. The operation is performed under subarachnoid or general anesthesia and lasts about 30-50 minutes. The removed tissue is sent for histopathological examination - the result is obtained after 2-3 weeks. After the testicle or testicles are excised, dentures can be inserted in their places.

After the procedure, the patient must stay in the ward for 1-2 days. On the second day, the drain (if fitted) is removed to drain the residual blood and serous exudate. Depending on the hospital, sutures are applied to the wound, which must be removed after 7 days, or dissolving. For some time after the procedure, the patient may complain of pain when touching the operated areas.

If the cause of the orchiectomy was cancer and chemotherapy was also initiated after the surgery, remember that you can try for a child only 2 years after thattreatment. For 5 years after the procedure, a man should also regularly check himself / herself to exclude a possible recurrence of the cancer.

Complications after removal of the testicle

Each operation carries certain risks, and this is also the case with an orchidectomy. An undesirable effect of testicular amputation can be:

  • scrotal hematoma
  • groin hematoma or retroperitoneal hematoma (in case of radical orchiectomy)
  • inflammation in the area of ​​the scrotum, groin
  • feeling disturbed of this place
  • local recurrence of the tumor (from unintentional cells left behind)
  • phantom pains

If a man experiences any disturbing symptoms related to a recent operation shortly after returning home, he should immediately see a doctor.

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Male diseases