Radical orchiectomy is surgery to remove a testicle. It’s most often done to treat testicular cancer. Or, it may be needed if a testicle is severely damaged due to infection or injury. Some forms of treatment for prostate cancer include orchiectomy. The penis is not affected by the surgery. The scrotum (sac of skin that holds the testicles) remains intact after surgery.
Changes in your body
Having a testicle removed can affect how you feel about your body. It may help to talk with a mental health professional before or after the procedure. In some cases, an artificial testicle (prosthesis) can be placed during surgery or at a later time. You and your doctor can discuss whether this is an option for you. Having a testicle removed could affect your fertility. If you want to have children, you may choose to store sperm before the procedure as a precaution. Talk to your doctor about this.
Preparing for surgery
Prepare for the surgery as you have been told. In addition:
Tell your doctor about all medicines you take which includes over-the-counter medicines, herbs and other supplements. It also includes any blood thinners, such as warfarin, clopidogrel, or daily aspirin. You may need to stop taking some or all of them before surgery, as instructed by your doctor.
Don't eat or drink during the 8 hours before your surgery. This includes coffee, water, gum, and mints. (If you have been instructed to take medicines, take them with a small sip of water.
The day of surgery
The surgery takes about 1 hour(s). You may go home the same day or spend one or more nights in the hospital.
Before the surgery begins:
An intravenous line (IV) line is put into a vein in your arm or hand. This line delivers fluids and medicines (such as antibiotics).
You may get medicine to prevent blood clots.
To keep you free of pain during the surgery, you’re given general anesthesia. This medicine puts you into a state like deep sleep through the surgery. A tube may be inserted into your throat to help you breathe. Spinal anesthesia and local anesthesia are also options.
During the surgery:
An incision is made in the groin.
The testicle is removed. In cases of testicular cancer, the spermatic cord may also be removed. This structure contains nerves, arteries, and a tube that carries sperm away from the testicle.
When the surgery is done, the incision is closed with stitches or staples. These may need to be removed by the doctor at a follow-up visit.
After the surgery
You will be taken to the recovery room to be monitored as you wake up from the anesthesia. You may feel sleepy and nauseated. If a breathing tube was used, your throat may be sore at first. An ice pack may be applied to the surgical area. This helps reduce swelling. You may also be given a jockstrap to wear. This helps relieve pain and swelling, and prevents injury. Once you are ready to go home, have a responsible adult family member or friend drive you.
Recovering at home
Follow the instructions you have been given to care for yourself. During your recovery:
To help reduce swelling, apply an ice pack or cold compress to the scrotum as directed. Do this for no longer than 15 minutes at a time. Continue using the cold pack for 3 days or until swelling improves.
Take prescribed pain medicine as directed.
Care for your incision as instructed. Check the incision daily for signs of infection (listed below).
Follow your doctor’s guidelines for showering. Avoid swimming, bathing, using a hot tub, and other activities that cause the incision to be covered with water until your doctor says it’s OK.
Wear a jockstrap or snug underwear as directed.
Avoid heavy lifting and strenuous exercise as directed.
Don't have sex for 4 weeks.
Don't drive until you are no longer taking pain medicine and your doctor says it’s OK.
When to call your healthcare provider
Call your healthcare provider right away if you have any of the following:
Chest pain or trouble breathing (call 911)
Fever of 100.4°F (38°C) or higher, or as directed by your healthcare provider
Symptoms of infection at the incision site such as increased redness or swelling, warmth, worsening pain, or foul-smelling drainage
Increased pain or swelling in the scrotum or groin area
Pain that is not relieved by pain medicine
You will have follow-up visits so your doctor can check on your healing. Stitches or staples may need to be removed. You and your doctor can also discuss any further treatments you may need.
Risks and possible complications
Bleeding (may require a blood transfusion)
Damage to nearby nerves, blood vessels, soft tissues, and organs
Changes in hormone levels
Recurrence of cancer or failure to keep cancer from spreading
Risks of anesthesia. The anesthesiologist will discuss these with you.
September 15, 2017
Radical inguinal orchiectomy for testicular germ cell tumors, Up To Date
Greenstein, Marc, DO,Sather, Rita, RN