Orchidectomy
What is an Orchidectomy?
An orchidectomy is a surgical procedure to remove one or both testicles. It is most commonly performed to treat testicular cancer, but it may also be recommended for advanced prostate cancer, severe testicular injury, chronic testicular pain in carefully selected cases, or other conditions affecting the testis.
When only one testicle is removed, the remaining testicle usually continues to produce testosterone and sperm, although fertility may be affected depending on the underlying condition and any additional treatments. An orchidectomy is typically performed as a day-case or short-stay procedure under general anaesthetic.
What are the Benefits of an Orchidectomy?
An orchidectomy can provide effective treatment for several urological conditions.
Benefits include:
- Primary treatment for most cases of testicular cancer
- Rapid removal of cancerous tissue
- Helps diagnose the exact type of testicular tumour
- Effective hormonal treatment for advanced prostate cancer
- Relief from symptoms caused by certain testicular conditions
- Minimally invasive procedure with a relatively short recovery
- Can reduce the need for additional emergency treatment in selected cases
- Allows further treatment to be planned based on pathology results
When is an Orchidectomy Recommended?
Your urologist may recommend an orchidectomy for several medical reasons.
It is commonly recommended for:
- Suspected or confirmed testicular cancer
- Advanced or metastatic prostate cancer requiring hormone suppression
- Severe trauma causing irreparable damage to the testicle
- Testicular torsion when the testicle cannot be saved
- Persistent testicular pain when other treatments have failed in carefully selected patients
- Certain severe infections or non-functioning testicles
The procedure is recommended only after careful clinical assessment and appropriate imaging.
What does Preparation for an Orchidectomy Involve?
Before surgery, your urologist will perform a thorough assessment to confirm the diagnosis and plan treatment.
Preparation may include:
- Physical examination
- Ultrasound scan of the scrotum
- Blood tests, including tumour markers if testicular cancer is suspected
- CT scan if cancer staging is required
- Review of medications, including blood-thinning medicines
- Fasting instructions before general anaesthetic
- Discussion of fertility preservation, including sperm banking where appropriate
- Explanation of the procedure, potential risks, and expected recovery
Some patients may also choose to discuss the option of a testicular prosthesis, which can be inserted during the same operation or at a later date.
How is an Orchidectomy Performed?
An orchidectomy is usually performed under general anaesthetic and typically takes between 30 and 60 minutes.
For suspected testicular cancer, the operation is performed through a small incision in the groin rather than through the scrotum. This approach reduces the risk of spreading cancer cells and allows the surgeon to remove the entire testicle and spermatic cord safely. The blood vessels and vas deferens are carefully divided before the testicle is removed.
For patients undergoing orchidectomy as treatment for advanced prostate cancer or other non-cancerous conditions, the surgical technique may vary slightly depending on the indication.
The incision is then closed with dissolvable stitches, and a dressing is applied. Most patients are able to return home later the same day or after an overnight stay.
What to Expect during Recovery after an Orchidectomy?
Recovery is generally straightforward, although healing times vary between individuals.
During recovery, patients can expect:
- Mild discomfort and swelling around the groin
- Bruising that gradually resolves over one to two weeks
- Advice to wear supportive underwear for comfort
- Return to light daily activities within several days
- Avoidance of heavy lifting and strenuous exercise for approximately two to four weeks
- Follow-up appointments to review healing and discuss pathology results
If the procedure was performed for testicular cancer, additional treatment such as surveillance, chemotherapy, radiotherapy, or further surgery may be recommended depending on the pathology findings.
What are the Risks and Complications of an Orchidectomy?
Orchidectomy is a commonly performed procedure and is generally very safe, although all surgery carries some potential risks.
Possible complications include:
- Bleeding or haematoma
- Infection
- Temporary pain or swelling
- Wound healing problems
- Injury to surrounding structures, although uncommon
- Changes in fertility, particularly if both testicles are affected or further cancer treatment is required
- Reduced testosterone levels if both testicles are removed
- Emotional or psychological adjustment following loss of a testicle
- Rare chronic groin discomfort
Your urologist will explain the reasons for recommending an orchidectomy, discuss the expected benefits and potential risks, and ensure you understand the procedure and any additional treatments that may be required.