Inguinal Orchiectomy
Topic at a Glance
- Inguinal orchiectomy is the surgical removal of one or both testicles.
- The procedure may also be recommended for prostate cancer, male breast cancer, severe testicular injury, testicular torsion, or other medical conditions.
- Recovery usually takes 2–4 weeks and involves limiting physical activity while the surgical site heals.
- Most men recover well after surgery, although fertility, hormone levels, and the need for additional cancer treatment may be needed, depending on the reason for the procedure.
Inguinal orchiectomy is the surgical removal of one or both testicles. An orchiectomy is typically used to treat patients with testicular cancer, male breast cancer, and prostate cancer.
If you have questions regarding radical inguinal orchiectomy, schedule a consultation with our team at Urology of Greater Atlanta. Our expert urologists offer accurate diagnoses and tailor-made treatment plans. Call or book an appointment now.
When is an Inguinal Orchiectomy Needed?
According to the National Cancer Institute, this is the procedure of choice for testicular cancers. A doctor may also recommend an orchiectomy when a patient has breast cancer or prostate cancer. When the testicles are removed, the body cannot produce as much testosterone.
Testosterone can cause cancer to spread quickly throughout the body. Therefore, a physician may recommend orchiectomy to reduce the growth rate of the cancer and lessen symptoms such as pain in the bones.
Your physician may also recommend orchiectomy to treat the following conditions:
- Severe trauma to the testicle
- Testicular torsion (when the spermatic cord becomes twisted, cutting off blood supply to the testicles)
- Undescended testicles after puberty
- Transitioning from male to female
What Are the Different Types of Orchiectomy Procedures?
The different kinds of orchiectomy surgical procedures include:
- Simple orchiectomy: The removal of either one testicle or both testicles and a section of the spermatic cord through a minor incision in the scrotum. For cosmetic purposes, a doctor can offer a testicular prosthesis as an option before closing the incision, although not every patient chooses one.
- Bilateral orchiectomy: A bilateral orchiectomy is the removal of both testes.
- Subcapsular orchiectomy: A subcapsular orchiectomy is the removal of only the tissue surrounding the testicles.
- Radical Orchiectomy: A procedure used to remove a cancerous testicle. In this case, one or both testicles are removed, as well as the cancerous tumor and the spermatic cord.
What Happens During a Radical Inguinal Orchiectomy Procedure?
Before the surgical procedure, a diagnosis is usually reached through scrotal ultrasound and blood work. The procedure is usually performed as an outpatient procedure under local or general anesthesia.
- Your surgeon will begin by making a small incision (cut) in your groin area. This opening allows the doctor safe access to the treatment site.
- Through this incision, the surgeon will carefully remove the affected testicle and the cancerous tumor.
- Next, the surgeon will gently remove the spermatic cord through the inguinal canal. This is a vital preventive step, as the cord contains the vas deferens, blood vessels, and lymphatic vessels, which can serve as pathways for cancer cells to spread to other parts of the body.
- Depending on your specific case and the stage of the cancer, your doctor might also perform a retroperitoneal lymph node dissection. This involves removing nearby lymph nodes on the same side as the affected testicle to further protect against the spread of cancer.
- At this stage, your surgeon can insert a natural-looking prosthetic testicle. The prosthesis is typically made from a silicone shell filled with saline.
- Before the closure of the incision, your physician will thoroughly wash the area with a sterile saline solution. They will then carefully sew the incision together with stitches.
What Happens After an Inguinal Orchiectomy Procedure?
After the surgery, patients usually go home the same day. You might experience discomfort in the groin and scrotum for about a week. If the pain is severe and lasts longer than a week, notify your healthcare provider.
Other things to expect after an orchiectomy procedure:
- A patient may need to wear a scrotal support garment for the first two days after the surgery.
- Activities such as exercise, sports, and sex need to be limited for several weeks after surgery, though the procedure does not affect erectile function.
- Avoid straining during bowel movements (increase fiber in your diet and drink plenty of water).
- Avoid lifting heavy objects over 10 pounds for the first two to four weeks after surgery.
Most men maintain normal testosterone levels after one orchiectomy. If the operation wasn’t done to reduce testosterone, replacement may be needed.
It usually takes two to four weeks to fully recover from the inguinal orchiectomy procedure.
Fertility can be affected following the procedure. Some men who plan to have a family in the future choose to store their sperm in a sperm bank as a precaution.
In some cases, additional treatment such as chemotherapy is needed.
Possible Risks and Complications After an Orchiectomy
Like any surgical procedure, an orchiectomy procedure may cause a few complications.
Therefore, a patient should notify their doctor if complications such as the following are noticed right after the surgery:
- A hematoma, or bleeding into the scrotum
- A nerve injury during dissection of the spermatic cord can decrease the sensation on the inside of the thigh, scrotum, or base of the penis
- Redness, pus, or bleeding at the site of surgery
- Severe pain
- Loss of muscle strength
- Inability to urinate
- A fever of over 100°F
- Inguinal hernia if the external oblique fascia is not properly closed
The surgery might cause further complications in time, such as the following:
- Low testosterone (often treated with hormone therapy)
- Low sex drive
- Infertility
- Erection
- Fatigue
- Weight gain
- Hot flashes
- Osteoporosis
- Blood clots
- Hemorrhaging, or internal bleeding
- Gynecomastia, or breast enlargement
- Infection
If you are experiencing any of the symptoms or complications above, be sure to contact your healthcare provider.
Inguinal Orchiectomy in Atlanta, Georgia
If you have questions or concerns regarding inguinal orchiectomy, then make an appointment to speak to one of the urologists at Urology of Greater Atlanta.
Our expert urologists provide state-of-the-art diagnosis and personalized treatment. Call or book an appointment now.
FAQs About Inguinal Orchiectomy
Why is an inguinal orchiectomy performed?
An inguinal orchiectomy is most commonly performed to treat testicular cancer by removing the affected testicle through an incision in the groin. It may also be recommended for prostate cancer, male breast cancer, severe testicular trauma, testicular torsion, or other specific medical conditions.
What happens during a radical inguinal orchiectomy?
During a radical inguinal orchiectomy, the surgeon removes the affected testicle, the spermatic cord, and the cancerous tissue through a small incision in the groin. In some cases, nearby lymph nodes may also be removed. A testicular prosthesis can be placed if desired.
How long does it take to recover from an inguinal orchiectomy?
Most patients return home the same day as surgery. Full recovery can take 2–4 weeks. During recovery, you’ll need to avoid heavy lifting, strenuous exercise, sexual activity, and other activities that could strain the surgical area until your doctor says it’s safe.
Can I have children after an orchiectomy?
Many men remain fertile after the removal of one testicle because the remaining testicle can continue producing sperm and testosterone. However, fertility may be affected depending on your overall health, cancer treatment plan, or if both testicles are removed. Your urologist may discuss sperm banking before surgery if future fertility is a concern.
What are the possible risks of an inguinal orchiectomy?
Potential risks include bleeding, infection, hematoma, nerve injury, severe pain, difficulty urinating, and inguinal hernia. Long-term effects may include low testosterone, infertility, reduced sex drive, fatigue, osteoporosis, hot flashes, or gynecomastia, particularly if both testicles are removed or hormone levels decrease.
