Resources

Orchiectomy

An orchiectomy, also known as orchidectomy, is a surgical procedure involving the removal of one or both testicles. This procedure can be conducted for various medical reasons, including testicular cancer, prostate cancer, testicular torsion, severe trauma, and gender-affirming surgery for transgender women.

Types of Orchiectomy

There are mainly three types of orchiectomy: simple, subcapsular, and inguinal.

  1. Simple Orchiectomy: This is the most common form, involving the removal of the testicles through an incision in the scrotum. It is typically performed under local or general anesthesia and is often chosen for individuals undergoing gender-affirming surgery or treating advanced prostate cancer.
  2. Subcapsular Orchiectomy: During this procedure, the surgeon removes the glandular tissue from the testicles while leaving the tunica albuginea intact. This method is less common and is usually performed to treat prostate cancer without removing the entire testicle.
  3. Inguinal Orchiectomy: This is a more extensive procedure where the testicle is removed through an incision in the groin rather than the scrotum. It is primarily used to treat testicular cancer, allowing the surgeon to remove the spermatic cord and reduce the risk of cancer spreading.

Indications for Orchiectomy

  • Testicular Cancer: The primary treatment for testicular cancer involves the removal of the affected testicle to prevent the spread of cancer.
  • Prostate Cancer: Orchiectomy can be a treatment option to reduce testosterone levels, which can help slow the growth of prostate cancer cells.
  • Testicular Torsion: In severe cases where blood flow is not restored to the twisted testicle, orchiectomy may be necessary to prevent complications.
  • Trauma: Significant injury to the testicles may necessitate orchiectomy if the organ is severely damaged.
  • Gender Affirming Surgery: Transgender women may opt for orchiectomy as part of their transition process.

Procedure and Recovery

The orchiectomy procedure typically lasts about 30 minutes to an hour and can be performed on an outpatient basis. The patient is placed under anesthesia, and the surgeon makes an incision to remove the testicle(s). After the surgery, patients usually can go home the same day.

Recovery time varies depending on the type of orchiectomy and the individual’s overall health. Patients are advised to avoid strenuous activities for a few weeks and may experience discomfort, which can be managed with prescribed pain medication. Follow-up appointments are necessary to monitor recovery and address any potential complications.

Risks and Complications

Like any surgical procedure, orchiectomy carries certain risks, such as infection, bleeding, and reactions to anesthesia. Other potential complications include:

  • Chronic pain or discomfort in the scrotal area
  • Changes in sexual function or desire
  • Psychological impact, particularly concerning body image or masculinity
  • Hormonal imbalances if both testicles are removed, requiring hormone replacement therapy

Conclusion

Orchiectomy is a significant surgical procedure with various medical implications depending on the individual’s condition and the reason for the surgery. Patients considering orchiectomy should discuss all potential risks, benefits, and alternatives with their healthcare provider to make an informed decision. Post-surgical care and monitoring are crucial for a successful recovery and managing any long-term effects of the surgery.