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  • Orchiectomy

    Definition

    Orchiectomy is a surgery to remove one or both testicles.
    Male Genitalia
    IMAGE
    Copyright © Nucleus Medical Media, Inc.

    Reasons for Procedure

    An orchiectomy may be done to treat:
    It can also be a diagnostic procedure to determine if cancer is present when a mass is found during ultrasound.

    Possible Complications

    If you are planning to have an orchiectomy, your doctor will review a list of possible complications, which may include:
    • Nerve injury or damage to surrounding tissue or structures
    • Bleeding
    • Infection
    • Reaction to anesthesia
    Factors that may increase the risk of complications include:
    Discuss these risks with your doctor before the surgery.

    What to Expect

    Prior to Procedure

    Your doctor and anesthesiologist may do the following:
    • Examine you
    • Do imaging, blood, and urine tests
    • Discuss the anesthesia being used and the potential risks
    Talk to the doctor about your medicines. You may be asked to stop taking some medicines up to one week before the procedure, like:
    • Aspirin or other anti-inflammatory drugs
    • Blood thinners (eg, warfarin , clopidogrel )
    Other things to keep in mind before the procedure:
    • Arrange for a ride home from the hospital.
    • In most cases, you will need to avoid eating and drinking for 6-8 hours before the procedure. Ask your doctor when you should stop eating and drinking.

    Anesthesia

    The procedure is done under general or spinal anesthesia . You will be asleep or sedated. Anesthesia will block any pain during the surgery.

    Description of Procedure

    You will be prepared for surgery. The genital area will be shaved and sterilized. An IV will be placed in your arm for medicines and fluids.
    Once you are asleep, the doctor will make a small incision in the groin area or in the scrotum. The testicle is pulled up from the scrotal sac. The cord that connects the testicle to the scrotum is clamped and sutured. The testicle is removed. Absorbable stitches will be used to close all incision areas.
    A prosthetic testicle is sometimes placed into the scrotum. This can be done at the time of the surgery or at a later date.

    How Long Will It Take?

    About one hour per testicle

    How Much Will It Hurt?

    You will not feel any pain during the procedure. The doctor will give you pain medicine when you wake up.

    Post-procedure Care

    At the Care Center
    The staff may provide the following care to make you more comfortable and help your recovery:
    • Pain medicines and IV fluids
    • Ice pack and other scrotal support
    You will be able to leave when the anesthesia has worn off and you can walk.
    At Home
    When you return home, do the following to help ensure a smooth recovery:
    • Walking and light activity is important. Avoid strenuous activities and heavy lifting for a few weeks.
    • Swelling and soreness is normal. Try using ice packs or rolled towels. Take pain medicines as directed. Your doctor may recommend that you wear snug-fitting underwear and a jock strap for the first few days.
    • Keep the incision site clean and dry:
      • Clean the incision site with lukewarm water and mild soap. Do this beginning the day after the surgery.
      • Use a soft wash cloth to gently wipe the incision area.
    • Ask your doctor about when it is safe to shower, bathe, or soak in water.
    • Be sure to follow your doctor’s instructions.

    Call Your Doctor

    After arriving home, contact your doctor if any of the following occurs:
    • Increasing pain, discharge, redness, or swelling at the incision site
    • Pus or odor from the incision site
    • A lot of bleeding
    • Stitches loosen or fall out
    • Signs of infection, including fever and chills
    In case of an emergency, call for medical help right away.

    RESOURCES

    American Urological Association http://www.auanet.org/

    Testicular Cancer Resource Center http://tcrc.acor.org/

    CANADIAN RESOURCES

    Canadian Urological Association http://www.cua.org/

    Health Canada http://www.hc-sc.gc.ca/index-eng.php

    References

    Orchiectomy. In: Khatri V. Operative Surgery Manual . Philadelphia, PA: Saunders Elsevier; 2003: chap 46.

    Orchiectomy surgery. St. Joseph’s Healthcare Hamilton website. Available at: http://www.stjoes.ca/media/PatientED/K-O/PD%206660%20Orchiectomy%20Surgery.pdf . Updated August 2009. Accessed August 17, 2010.

    Ryan C, Small E, Torti F. Testicular cancer. In: Abeloff M. Abeloff’s Clinical Oncology . 4th ed. Philadelphia, PA: Churchill Livingstone Elsevier; 2008: chap 90.

    Testicular cancer treatments: the inguinal orchiectomy. Testicular Cancer Resource Center website. Available at: http://tcrc.acor.org/orch.html . Updated June 21, 2009. Accessed August 17, 2010.

    6/6/2011 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : Mills E, Eyawo O, Lockhart I, Kelly S, Wu P, Ebbert JO. Smoking cessation reduces postoperative complications: a systematic review and meta-analysis. Am J Med. 2011;124(2):144-154.e8.

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