Orchiectomy

Orchiectomy is a surgical procedure that may involve the removal of one testicle (unilateral orchiectomy) or both testicles (bilateral orchiectomy). The surgery can be performed through different techniques depending on the underlying condition being treated. The primary goal of orchiectomy is to eliminate diseased tissue, reduce hormone levels (particularly testosterone), or address anatomical concerns.

Reasons for Orchiectomy

There are several medical conditions that may necessitate an orchiectomy:

• Testicular Cancer: The most common reason for orchiectomy is the presence of cancer in one or both testicles. Removing the affected testicle(s) helps prevent the spread of cancer.
• Prostate Cancer: In cases where prostate cancer has advanced, orchiectomy may be performed to reduce testosterone levels, which can fuel cancer growth.
• Male Breast Cancer: Orchiectomy may be recommended as part of treatment for male breast cancer.
• Undescended Testicle: If a testicle has not descended into the scrotum by puberty, surgical intervention may be necessary.
• Severe Trauma: Trauma to the testicles that results in significant damage may require removal.
• Testicular Torsion: This condition occurs when the spermatic cord becomes twisted, cutting off blood supply to the testicle. If not treated promptly, it can lead to necrosis (tissue death).

Types of Orchiectomy Procedures

There are several types of orchiectomy procedures:

1. Simple Orchiectomy:
   • This involves removing one or both testicles through a small incision in the scrotum. It is often performed for conditions such as testicular cancer or as part of gender-affirming surgery.
2. Radical Inguinal Orchiectomy:
   • This technique involves removing one or both testicles through an incision made in the groin area. It is commonly used when there is a suspicion of cancer to allow for better examination and staging.
3. Subcapsular Orchiectomy:
   • In this procedure, only the tissue surrounding the testicle is removed while leaving the outer shell intact. This method helps maintain a natural appearance and may be used in specific cases where complete removal isn’t necessary.

The Surgical Procedure

Preoperative Consultation

Before undergoing an orchiectomy, patients will have an initial consultation with a healthcare provider. During this meeting:

• The provider will review your medical history and discuss your reasons for seeking the procedure.
• A physical examination will be conducted to assess your condition.
• The provider will explain what to expect during the surgery and answer any questions you may have.

Anesthesia

Orchiectomy can be performed under local anesthesia with sedation or general anesthesia, depending on individual circumstances and patient preference.

Surgical Steps

1. Incision: Depending on the type of orchiectomy being performed, an incision will be made either in the scrotum or in the groin area.
2. Removal of Testicle(s): The surgeon will carefully remove one or both testicles along with any necessary surrounding tissue.
3. Closure: After removing the testicle(s), the incision will be closed using sutures or surgical clips.
4. Recovery Room: Patients are typically monitored in a recovery room before being discharged home.

Duration of Surgery

The entire procedure usually takes about 30 minutes to an hour, depending on whether one or both testicles are being removed and the complexity of the case.

Recovery Process

Recovery from an orchiectomy varies by individual but generally includes:

Initial Healing

Patients can expect some swelling, bruising, and discomfort in the days following surgery. Pain medication will be prescribed to manage any discomfort during this period.

Activity Restrictions

Most patients are advised to avoid strenuous activities for at least two weeks after surgery. Light walking is encouraged to promote circulation but should be done cautiously.

Follow-Up Care

Your healthcare provider will schedule follow-up appointments to monitor your healing progress and remove any non-dissolvable sutures if necessary. It’s essential to adhere to aftercare instructions provided by your healthcare team for optimal recovery.

Full Recovery

While initial swelling may subside within a week or two, complete recovery may take several weeks as final results become apparent. Patients usually begin seeing noticeable improvements shortly after surgery as swelling decreases.