Orchidectomy

• Orchidectomy is the surgical removal of one or both testicles, performed for medical reasons such as cancer, trauma, or hormonal therapy.
• The procedure varies, with common types including radical inguinal, simple, and subcapsular orchidectomy, each suited for different conditions.
• Primary reasons for orchidectomy include testicular cancer diagnosis and treatment, severe infections, trauma, and as a hormonal therapy for prostate cancer.
• Orchidectomy surgery recovery time typically involves a few days of rest, with full recovery and return to normal activities often within 2 to 4 weeks.
• Patients should discuss potential impacts on fertility, hormone levels, and body image with their healthcare provider.

What is Orchidectomy: Procedure and Types Explained

Orchidectomy refers to the surgical removal of one or both testicles. This procedure is a critical intervention in various medical contexts, ranging from oncology to managing severe infections or trauma. The decision to perform an orchidectomy is always made after careful consideration of the patient’s specific condition and overall health.

The orchidectomy procedure typically involves an incision, the location of which depends on the type of orchidectomy being performed. During the surgery, the spermatic cord, which contains blood vessels and the vas deferens, is carefully clamped and severed before the testicle is removed. The wound is then closed with sutures. The specific approach and extent of removal are tailored to the underlying medical reason for the surgery.

There are several types of orchidectomy explained, each designed for different clinical scenarios:

• Radical Inguinal Orchidectomy: This is the most common type performed when testicular cancer is suspected or confirmed. The incision is made in the groin, and the entire testicle, along with the spermatic cord, is removed. This approach helps prevent the spread of cancer cells.
• Simple Orchidectomy: In this procedure, the testicle is removed through an incision directly on the scrotum. It is typically performed for non-cancerous conditions such as severe infection, trauma, or as a palliative measure for advanced prostate cancer to reduce testosterone levels.
• Subcapsular Orchidectomy: This involves removing only the glandular tissue of the testicle while leaving the outer capsule. It is primarily performed for advanced prostate cancer to reduce testosterone production, which can slow the growth of hormone-sensitive prostate cancer.

Reasons for Orchidectomy

The reasons for orchidectomy are diverse and primarily revolve around treating or managing serious medical conditions affecting the testicles or requiring hormonal manipulation. One of the most common indications is testicular cancer. Testicular cancer is relatively rare but is the most common cancer in American males between the ages of 15 and 35, according to the American Cancer Society. An orchidectomy is often the first step in both diagnosing and treating this malignancy.

Beyond cancer, other medical conditions necessitate this surgery. Severe trauma to the testicle that results in irreparable damage, such as a rupture or extensive injury, may require removal to prevent complications like infection or necrosis. Similarly, severe infections that do not respond to antibiotic treatment and threaten the patient’s health might lead to an orchidectomy. In some cases, an undescended testicle (cryptorchidism) that cannot be surgically brought into the scrotum and poses a risk of malignancy or other complications may also be removed.

Furthermore, bilateral orchidectomy (removal of both testicles) can be performed as a form of hormonal therapy for advanced prostate cancer. Since testosterone fuels the growth of most prostate cancers, removing the testicles significantly reduces the body’s testosterone production, thereby slowing disease progression.

Orchidectomy Surgery Recovery Time

Understanding the orchidectomy surgery recovery time is crucial for patients undergoing the procedure. Immediately after surgery, patients typically experience some pain, swelling, and bruising in the groin or scrotal area, which can be managed with prescribed pain medication. Most patients are discharged within 24 hours, depending on the type of orchidectomy and their overall health.

For the first few days post-surgery, rest is paramount. Patients are generally advised to avoid strenuous activities, heavy lifting, and sexual activity for at least two to four weeks to allow the incision to heal properly and minimize the risk of complications. Applying ice packs to the surgical site can help reduce swelling and discomfort. Wearing supportive underwear or a scrotal support can also provide comfort and reduce swelling.

Full recovery, including the resolution of swelling and a return to normal daily activities, typically occurs within two to four weeks. However, individual recovery times can vary based on the patient’s age, overall health, and the specific type of orchidectomy performed. Follow-up appointments with the surgeon are essential to monitor healing and discuss any concerns, including potential impacts on hormone levels, fertility, and body image. Patients may also discuss options for testicular prostheses if desired.