Orchiectomy

Why is this procedure done?

The testes are small round organs located in the skin sac or scrotum that hangs between a mans legs. The testes are also called testicles. The testicles make sperm and a hormone called testosterone. Testosterone is very important for growth and development in boys. Testosterone is also important making a man's sexual traits. ‚
The surgery to take out one or both of the testicles is called an orchiectomy. You may need this surgery: ‚

If you have a lump that needs to be removed.
To treat or prevent cancer.
As a part of a sex change operation.
If your testicle is injured in an accident.

Some people decide to have a testicular prosthesis or implant after a testicle is removed. The prosthesis is made of silicone or other materials and is filled with a sterile solution. After it is placed in the testicle sac, it looks and feels like your natural testicle. ‚
Talk with your doctor if you plan to have a child in the future. You may be able to bank sperm. ‚

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What will the results be?

One or both testicles will be removed. If you have cancer, this procedure may prevent spread of cancer cells. You will produce less testosterone. You may need hormone replacement therapy. ‚

What happens before the procedure?

Your doctor will take your history. Talk to your doctor about:
- All the drugs you are taking. Be sure to include all prescription and over-the-counter (OTC) drugs, and herbal supplements. Tell the doctor about any drug allergy. Bring a list of drugs you take with you.
- Any bleeding problems. Be sure to tell your doctor if you are taking any drugs that may cause bleeding. Some examples are Coumadin, ibuprofen, Aleve (naproxen), or aspirin. Certain vitamins and herbs, such as garlic and fish oil, may also add to the risk for bleeding. You may need to stop these drugs as well. Talk to your doctor about all of your drugs.
- When you need to stop eating or drinking before your procedure.
Your doctor will do an exam and may order:
- Lab tests
- Ultrasound
You and your doctor will talk about the use of a prosthesis for your testes.
The doctor may ask you to bathe using an antibacterial soap before going to the hospital.
You will not be allowed to drive right away after the procedure. Ask a family member or a friend to drive you home.

What happens during the procedure?

Once you are in the operating room, the staff will put an IV in your arm to give you fluids and drugs. You will be given a drug to make you sleepy. The drug will also help you stay pain free during the surgery. You may be asleep or awake during your surgery. You may be given drugs to make you pain free and numb from the chest down.
You will have a tube in your bladder to drain urine.
The staff may shave your scrotum before your surgery.
Your doctor will make a cut on the scrotum to find the testes. If the surgery is for testicular cancer, your doctor will make the cut in the groin area.
Your doctor will remove one or both testicles. Your doctor may put in the prosthesis during this time.
Your doctor will close the cut with stitches and cover the cut with a clean bandage.
The procedure will take 45 to 60 minutes.

What happens after the procedure?

You will go to the Recovery Room and the staff will watch you closely. You may have to stay in the hospital for 1 to 3 days.
You will have a support strap called a jock strap. The jock strap will help to hold the bandage in place and support the scrotum.
The numbness will most often go away 1 to 3 hours after the procedure. You will feel pain after the procedure. Your doctor will give you drugs for the pain.

What care is needed at home?

Ask your doctor what you need to do when you go home. Make sure you ask questions if you do not understand what you need to do.
Place an ice pack or a bag of frozen peas wrapped in a towel over the painful part. Never put ice right on the skin. Do not leave the ice on more than 10 to 15 minutes at a time.
Wear supportive underwear, like a jock strap, to elevate your scrotum.
Talk to your doctor about how to care for your cut site. Ask your doctor about:
- When you should change your bandages
- When you may take a bath or shower
- If you need to be careful with lifting things over 10 pounds
- When you may go back to your normal activities like work, driving, or sex
Be sure to wash your hands before and after touching your wound or dressing.

What follow-up care is needed?

Your doctor may ask you to make visits to the office to check on your progress. Be sure to keep your visits.
You may have stitches or staples. If so, your doctor will often want to remove the stitches or staples in 1 to 2 weeks.

What lifestyle changes are needed?

Get lots of bedrest. Lying down lessens the pressure of gravity on your scrotum.
You may have some discomfort while sitting the week after your procedure. Try using a donut cushion or pillow.
You should stop sitting on anything you would have to straddle until your next appointment. Some examples are bicycles, motorcycles, and horses.

What problems could happen?

Problems with erection
Infection
Bleeding
Urinary tract infection
Trouble passing urine
Not able to have a child, which is called being sterile.
Problems related to hormones like reduced sex drive, hot flashes, breast pain and enlargement, mood swings, weight gain, loss of calcium in the bones
Numbness in the groin or genitals

When do I need to call the doctor?

Signs of infection such as a fever of 100.4 ‚ °F (38 ‚ °C) or higher, chills, pain with passing urine.
Signs of wound infection such as swelling, redness, warmth around the wound; too much pain when touched; yellowish, greenish, or bloody discharge; foul smell coming from the cut site; cut site opens up.
Pain not relieved by drugs
Trouble passing urine or change in color and odor of urine
Throwing up
Lack of energy

Where can I learn more?

American Cancer Society ‚
http://www.cancer.org/Cancer/TesticularCancer/DetailedGuide/testicular-cancer-treating-surgery ‚

Consumer Information Use and Disclaimer

This information is not specific medical advice and does not replace information you receive from your health care provider. This is only a brief summary of general information. It does NOT include all information about conditions, illnesses, injuries, tests, procedures, treatments, therapies, discharge instructions or life-style choices that may apply to you. You must talk with your health care provider for complete information about your health and treatment options. This information should not be used to decide whether or not to accept your health care providers advice, instructions or recommendations. Only your health care provider has the knowledge and training to provide advice that is right for you. ‚

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