Orchiectomy

Also known as: radical inguinal orchiectomy, simple orchiectomy, bi-lateral orchiectomy

Orchiectomy is the removal of one or both testicles (testes) and is generally performed by a urologist. The testicles are the male sex organs that produce sperm and the male hormone, testosterone.

Why it is done
The two most common orchiectomy procedures are radical inguinal orchiectomy and simple orchiectomy.

A radical inguinal orchiectomy is done if a lump is found in a testicle and testicular cancer is suspected. The procedure involves removing the testicle through a surgical incision in the abdomen, leaving the scrotum intact and undisturbed. Any lumps found in the tissue are then examined to determine if they are cancerous. This is usually done as a first step in determining testicular cancer instead of taking a biopsy of the tissue. Biopsies are not performed due to the fear it can cause cancer cells to spread, making successful treatment more difficult.

A simple orchiectomy may be done as a type of hormone therapy to help relieve symptoms, prevent complications, and prolong survival for advanced prostate cancer or to treat male breast cancer. The testicle is removed through a small incision made in the scrotum, the sac that contains the testicles. Both testicles (bilateral orchiectomy) are usually removed if a decrease in testosterone is the desired outcome.

How well it works
Orchiectomy for testicular cancer
Orchiectomy is the most effective way to remove cancerous tumors of the testicles. In some cases, orchiectomy is followed by additional surgery to remove cancer that has spread or by other therapies such as chemotherapy or radiation therapy. For early-stage testicular cancer, orchiectomy may be the only treatment needed.

Orchiectomy for advanced prostate cancer
Hormone therapy is the main treatment for advanced prostate cancer. Bilateral orchiectomy is the fastest and simplest way to block testosterone production. But because it is irreversible, many opt for drug therapy to reduce testosterone before surgery. Patients should discuss all options and associated risks carefully with their physician.

What to expect after surgery
Orchiectomy can be done as an outpatient procedure or with a short hospital stay. Regular activities are usually resumed within 1 to 2 weeks. And a full recovery can be expected within 2 to 4 weeks.

Risks
Orchiectomy surgery is relatively low-risk, and complications are uncommon. But orchiectomy carries all the risks of any major surgery, including:

  • Reactions to anesthesia or medicines
  • Infection
  • Bleeding

Bilateral orchiectomy carries the possibility of side effects. They are related to the loss of testosterone following the removal of both testes. These include:

  • Infertility
  • Loss of sexual interest
  • Erection problems
  • Hot flashes
  • Breast enlargement (gynecomastia)
  • Weight gain
  • Loss of muscle mass
  • Osteoporosis
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