Radical Inguinal Orchiectomy

Surgery to remove a testicle with cancer is called a radical inguinal orchiectomy.

An incision is made just above the pubic area, and the testicle is gently removed from the scrotum through the opening. The surgeon then removes the entire tumour along with the testicle and spermatic cord. The spermatic cord contains part of the vas deferens, as well as blood and lymph vessels that could act as pathways for testicular cancer to spread to the rest of the body. To lessen the chance of this, these vessels are tied off early in the operation.

Overview

A radical orchiectomy is one aspect of the definitive treatment of testicular cancer.

Testicular cancer generally affects young men between puberty and age 35 years. Successful treatment incorporates a number of modalities, including radical orchiectomy, retroperitoneal lymph node dissection, chemotherapy, and radiation.

Radical inguinal orchiectomy is the primary treatment for nearly all stages and types of testicular cancer. A prosthetic, saline-filled testicle can be inserted if you choose.

Risks

The short-term risks of any type of surgery include reactions to anaesthesia, excess bleeding, blood clots, and infections. Most men will have at least some pain after the operation, which can be helped with pain medicines, if needed.

Impacts on sex life

Losing one testicle usually has no effect on a man’s ability to get an erection and have sex. But if both testicles are removed, sperm cannot be made and a man becomes infertile. Also, without testicles, a man cannot make enough testosterone, which can decrease sex drive and affect his ability to have erections. Other effects could include fatigue, hot flashes, and loss of muscle mass. These side effects can be avoided by taking testosterone supplements, either in a gel, a patch, or a shot. Pills are generally not reliable sources of testosterone.

Testicular prosthesis

Prostheses should be offered to all men undergoing orchiectomy. Not all men want a prosthesis — it is a personal decision. The prosthesis should be measured in the operating room with the patient asleep. The goal should be to match the remaining testicle in size, taking into account a cancerous testicle can be larger or smaller than normal, and the scrotal skin will make a prosthesis look larger once implanted.

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