What Is A Meniscectomy?
A meniscectomy is surgery performed to remove part or all of the testicles (testes) due to cancerous tumor(s). The word “men” means “to have”, so it refers to removing one’s own testicles. The term “removal” refers to removal of the whole testicle.
The word “reconstruction” refers to the reconstruction of the testicles. In other words, they are not removed completely but reconstructed from scratch.
Men with cancerous tumors may need both types of surgery: a total meniscectomy and reconstructive surgery. For example, if there is a mass in the scrotum, then a complete meniscectomy would include removal of the entire testicle.
If the mass is located in the groin area, then a reconstructive surgery might involve removal of only some of the testicle.
In general, most cancers do not spread very far from their original site. Therefore, many cases will go away without any treatment.
However, in rare cases where cancer spreads to distant parts of body such as lymph nodes or organs like lungs or liver, treatment is needed to prevent death due to metastasis.
A more specific term for this surgery is orchiectomy.
A meniscectomy is done under general anesthesia, which means that the patient is completely unconscious during the procedure and won’t remember a thing afterward. It is also feasible to perform this procedure under local anesthesia with sedation, in which case the patient is awake but extremely relaxed and drowsy.
Why Is It Done?
A meniscectomy is done to remove a testicle with a tumor that can’t be treated any other way. It especially applies to young people who wish to have children in the future. Sometimes a young person with cancer has chemotherapy and/or radiation therapy as treatment. However, these therapies can cause sterility (the inability to have children) or fertility problems even if the male doesn’t have cancer. This surgery ensures fertility after treatment. It is also done in cases of testicular torsion (twisting of a testicle, which causes ischemia or low blood supply). If not repaired quickly, the ischemia will cause necrosis or death of the tissue.
What Happens During the Procedure?
The removal and reconstruction of both testicles is done through one incision in the groin. In other words, an incision is made in the middle of the male’s groin. The cremaster muscle is separated in order to access the testicles. After identifying where the tumor is, the surgeon may remove part or all of one or both testicles. The surgery is done through an incision of about two to five inches (females can compare it to the incision size of a C-section).
If the tumor is small and doesn’t involve much of the testicle, then part of the testicle may be saved. In cases where necrosis has already occurred (dead tissue), the surgeon will remove as much as possible.
If there are any cancerous lymph nodes, these will also be removed. After surgery, the patient will have a drain in his scrotum for a few days to allow fluid buildup to drain out. This drain will eventually be removed.
Reconstructive scrotal surgery is done at the same time as the meniscectomy. After the remaining testicle is located, it is moved to the safest part of the scrotum.
In other words, if there is any dead or dying tissue on the testicle, it is removed and the working parts are shifted as high as possible in the scrotum. This allows for the best chance of ongoing fertility.
In some cases, tissue from the abdomen or thigh may be grafted into the scrotum to replace removed tissue, however this isn’t common and most often isn’t necessary if the working parts are still in good condition. The surgery is done through three to five small incisions, depending on how much work needs to be done.
Stitches are left to dissolve on their own.
What Are the Complications?
Complications depend on the type of cancer and the extent of the disease. If there are complications after surgery, they usually involve bleeding or infection. In very rare cases, a complication may cause death.
Most men who have had orchiectomies don’t experience pain after the surgery because the nerves that carry pain to the brain are cut during the procedure. Since these nerves still function before surgery, taking pain medication beforehand can alleviate any post-operative pain.
Some men experience a change in sexual desire and ability after orchiectomy. Even if fertility is preserved by reconstructive surgery, some men may have less sexual desire due to loss of a testicle.
These changes are usually only temporary however, and most men continue to have normal sexual functions.
Other Orchiectomy Information
Orchiectomy is one of the most effective forms of cancer treatment for early-stage cancers. In fact, the American Cancer Society recommends orchiectomy as the primary form of treatment for most small testicular cancers.
The procedure is also used on occasion as a means of birth control in some countries.
Complications after orchiectomy are rare, but they can include infection and damage to surrounding nerves, blood vessels, and structures within the scrotum. In very rare cases, orchiectomy can result in death.
After orchiectomy, men are often prescribed a course of hormones to take for the rest of their lives. These hormones help slow or stop development of any cancerous cells that remain in the body after surgery.
Men who have had orchiectomies should continue to undergo testing every couple years to ensure that all cancerous cells have been eliminated.
If you have any questions about orchiectomy, please talk with your physician.
Orchiectomy: Putting the “Or” in Orgasm
After the procedure, you’ll no longer have a testicle, unless you go in for reconstructive surgery. And while that may seem like the absolute worst thing that could happen to you, it’s not.
Most testicular cancers are highly survivable if caught in their earliest stages. And while it’s true that most of the time testicular cancer is caught late, this is mainly a problem with men who neglect their bodies and don’t have any symptoms at all.
If you follow this guide to the letter, you shouldn’t have any problem getting treatment early.
Another perk of being informed is that when you do lose a testicle, you’re going to be the life of the party. Seriously, you’re going to be the guy who tells the story of when he lost a nut.
You’ll gain much respect from your peers.
You’re going to be fine.
Sources & references used in this article:
Significant synovial pathology in a meniscectomy model of osteoarthritis: modification by intra-articular hyaluronan therapy by MM Smith, MA Cake, P Ghosh, A Schiavinato… – …, 2008 – academic.oup.com
Patellofemoral osteoarthritis coexistent with tibiofemoral osteoarthritis in a meniscectomy population by M Englund, LS Lohmander – Annals of the rheumatic diseases, 2005 – ard.bmj.com
Risk factors for meniscectomy after meniscal repair by S Lyman, C Hidaka, AS Valdez… – … American journal of …, 2013 – journals.sagepub.com
Motor recovery after arthroscopic partial meniscectomy. Analyses of gait and the ascent and descent of stairs. by A Durand, CL Richards, F Malouin, G Bravo – JBJS, 1993 – journals.lww.com