Orchiectomy is a surgical procedure in which one or both testicles are removed. It is performed for various reasons, including medical conditions such as testicular cancer, prostate cancer, gender confirmation surgery, or severe trauma to the testicles. Depending on the reason for the surgery, it can be either unilateral (removal of one testicle) or bilateral (removal of both testicles).
The procedure can also be referred to as scrotal surgery when performed in conjunction with the removal or modification of the scrotum, which houses the testicles.
Simple Orchiectomy: This is the most common form of the procedure, where the testicle is removed through a small incision in the scrotum. This surgery is typically performed for conditions like testicular cancer or to alleviate chronic pain caused by injury or infection.
Subcapsular Orchiectomy: In this procedure, only the tissue inside the testicle is removed, leaving the outer shell of the testicle behind. This is often done in prostate cancer patients to reduce testosterone levels, as testosterone can stimulate the growth of prostate cancer cells.
Radical Orchiectomy: This procedure involves the complete removal of the testicle along with surrounding structures. This surgery is usually done for patients diagnosed with testicular cancer.
Orchiectomy for Gender Confirmation: In transgender women, orchiectomy is often a part of gender-affirming surgery, where both testicles are removed to help align the individual’s body with their gender identity.
Orchiectomy can be recommended for various reasons:
Testicular Cancer: Removal of one or both testicles is a common treatment for testicular cancer. If the cancer is confined to one testicle, a unilateral orchiectomy may be performed.
Prostate Cancer: In some cases, especially in advanced prostate cancer, orchiectomy is performed to reduce testosterone levels in the body, as testosterone can promote cancer growth.
Gender Confirmation Surgery: For individuals undergoing male-to-female gender transition, orchiectomy is part of the surgical process to align the body with the individual’s gender identity.
Chronic Pain or Injury: In cases where a person suffers from ongoing testicular pain or significant injury, orchiectomy may be done to relieve discomfort.
Severe Testicular Trauma: If the testicle is damaged due to trauma or infection and cannot be repaired, it may need to be removed.
Preoperative Preparation: Before undergoing orchiectomy, a thorough evaluation is done to assess the patient’s medical history, overall health, and the specific reason for the surgery. Tests such as blood work and imaging (such as ultrasound) may be performed.
Anesthesia: Orchiectomy is typically performed under general anesthesia, though regional anesthesia (spinal or epidural) may also be used in certain cases. The patient will be asleep during the procedure.
Surgical Approach:
Closing the Incisions: Once the testicle(s) are removed, the incisions are sutured and closed. The recovery time for the procedure depends on the extent of the surgery, but it’s typically less invasive compared to open surgery for other conditions.
Postoperative Care: After surgery, the patient is monitored in a recovery room for a few hours before being discharged. Instructions on wound care, pain management, and avoiding heavy activities will be given.
Hospital Stay: Most patients can go home the same day or the next day after surgery. However, in some cases, if both testicles are removed, a longer hospital stay may be required.
Pain Management: Some discomfort is common post-surgery, and pain relief medications are prescribed. The pain usually subsides within a few days.
Swelling and Bruising: Swelling and bruising around the scrotum may occur but typically resolve within a few weeks. Wearing supportive underwear can help manage these symptoms.
Activity Restrictions: Patients are advised to avoid strenuous activities, heavy lifting, or sexual activity for at least 2-4 weeks to allow the body to heal.
Follow-Up Appointments: Regular follow-up visits are necessary to monitor for complications and check for any signs of infection or recurrence of cancer (if relevant).
While orchiectomy is generally a safe procedure, there are risks, including:
If you are considering orchiectomy, it is important to have an in-depth discussion with your urologist. Factors that influence the decision include:
Orchiectomy, whether performed for medical reasons or as part of gender-affirming surgery, can be a life-changing procedure. While the physical recovery is generally straightforward, it is crucial to consider the emotional and psychological aspects as well. If you have questions or concerns about orchiectomy or scrotal surgery, Dr. Mourad Abouelleil is here to guide you through the process and provide personalized care.
Contact us today for a consultation to discuss your treatment options and to learn more about how orchiectomy can improve your quality of life.
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