What to Expect from an Orchiectomy

What to expect from an Orchiectomy?

Orchiectomy is one of the most common surgeries performed nowadays. It is usually done when there are no other options available. There are many reasons why someone wants to have an orchid removed. Some of them include:

• For cosmetic purposes (e.g. vanity)

• To improve fertility (e.g. male factor infertility)

• To prevent cancer (e.g. cervical cancer)

• To reduce risk of heart disease (e.g. high cholesterol levels)

•To increase sexual pleasure and satisfaction (e.g. female factor sexual dysfunction)

•For medical reasons (e.g. endometriosis)

•To prevent pain during childbirth (e.g. labor pains)

Some of these reasons may not apply to you and some might even be negative ones. You will need to decide if having an orchid removed is right for you based on your individual situation. Your doctor will make this decision based on all the relevant facts and circumstances of your case.

Preparing for the Orchiectomy Surgery

Once you have made the decision to have your orchid removed, you will need to undergo a series of procedures before the surgery can take place. These are:

1. Consultation with your physician: During this visit, your physician will ask questions relating to your medical history, as well as perform a physical examination.

He or she will want to know what are your exact reasons for wanting an orchidectomy. As part of this process, you may be required to get an ultrasound or blood tests.

2. Mental preparation: Considering the fact that this is a surgical procedure which will be performed on your body, it is best to stay mentally prepared before and after the operation.

It may help to speak to a psychiatrist who can advise you on the matter.

3. Medication: In some cases, physicians may advise their patients to take certain drugs before and after the operation.

These might include antibiotics, pain killers, or hormones.

What Happens During an Orchiectomy?

The actual surgery is fairly quick and simple. It will take place in an operating room under local anesthesia. You might wish to bring a support person with you. The medical professional will make a small incision in the upper, lower, or side of your scrotum. The testes will then be exposed, and an instrument called a cannula is used to grab them on either side. They are then pulled forward and cut from the surrounding blood vessels and tissues. This is done to prevent bleeding or damage to these organs.

The removed organs are then checked for any cancerous cells or other abnormalities. Any such growths or abnormalities are biopsied and sent to a lab for examination. Once this process is complete, the remaining tissue is cauterized and the incisions are stitched up.

Recovering from an Orchiectomy

Fortunately, the recovery time after this procedure is fairly quick. Most men are able to go back to their normal routines within a week. There may be some pain, irritation, and swelling in the area for the first few days. Your physician may advise you to take pain relievers for this.

It is best to avoid any heavy physical activity or straining your abdominal muscles during this time.

It is also important that you keep the incision area clean and dry. You can let your scrotum hang freely or wear loose underwear. It is best to avoid wearing tight clothing, such as jeans, as it could interfere with wound healing. Your physician will give you specific post-operative instructions, but most men are able to return to work within a week.

Risks and Complications of Orchiectomy

As with any surgical procedure, there are certain risks and complications which could occur. The main potential problem is bleeding. It is very important that you do not engage in any activity which may cause excessive strain on your abdomen. This will include heavy lifting, jogging, and similar vigorous activity.

You should also avoid any direct blows to the incision area, such as getting hit with a baseball or football.

Other risks of this procedure may include infection, swelling, numbness, unevenness or asymmetry of the scrotum, and unsatisfactory cosmesis (appearance). Talk to your physician if you notice any redness, swelling, discharge, or increased pain at the incision site.

What is a Testicular Prosthesis?

If you have cancer that affects both of your testicles, orchiectomy alone may not be enough to stop the disease’s spread. In this case, your physician may advise a testicular prosthesis. This is an artificial testicle which can be implanted during the orchiectomy procedure. It will allow the patient to retain masculine characteristics including maintenance of male hormones and sexual function. This prosthesis is not an option for all men, so be sure to discuss your concerns and questions with your physician.

Is there anything else I should know?

Prostate cancer is one of the most common cancers among men. It is more common in older men, but does occur in younger men as well. Fortunately, it is also highly treatable, so it is important that you familiarize yourself with the symptoms and seek treatment as soon as possible. Unfortunately, many men suffer from denial and ignore the symptoms of prostate cancer.

If you feel that you are in any way at risk for prostate cancer, it is important that you bring this up with your physician. Prostate cancer can often be effectively treated if identified early. It may also help to familiarize yourself with other symptoms of prostate cancer to ensure that you receive a prompt diagnosis.

Questions to ask your doctor

Does my family have a history of prostate cancer?

Are there any factors that I should be aware of that might increase my risk of prostate cancer?

Am I at increased risk based on my race?

Have I been exposed to Agent Orange or any other chemicals?

Do I have a family history of testicular cancer?

(If diagnosed with prostate cancer, I may be at risk for testicular cancer as well)

Should I undergo blood tests to identify cancer markers?

What steps can I take to reduce my risk of prostate cancer?

What is the usual course of treatment for prostate cancer?

What are my treatment options?

What will happen during treatment?

Will I experience any side effects from the treatment?

How successful is this treatment?

How long will I need to be treated?

Are there any complementary therapies that can help me with this condition? What are they?

What happens if I don’t receive treatment? What are my survival odds?

Are there any clinical trials that I can participate in?

What research is being done on this disease?

Appendix A: Glossary

amenorrhea: the absence of a menstrual cycle in a woman.

androgen: any male hormone, such as testosterone. Androgens stimulate the growth of prostate cancer cells, so lowering androgen levels slows down the progression of the disease.

benign: a condition that is harmless. Benign conditions will not spread or threaten other aspects of your health.

biopsy: the process of taking a sample of tissue to examine it more closely. A pathologist examines the sample to determine the condition of the tissue.

brachytherapy: a radiation treatment where a small container of radioactive material (i.e. iodine-125) is placed next to (“braced” against) the area of prostate cancer. This treatment is usually used to destroy small areas of cancer, and is less damaging to surrounding organs than traditional external beam radiation therapy.

chemotherapy: a general term for the use of drugs to treat disease; in oncology it most commonly refers to the use of drugs to treat cancer. While chemotherapy can be useful in combination with other treatments to reduce the size of tumors to make them more responsive to other types of treatment, it does not destroy cancer cells directly.

cryosurgery: a treatment for prostate cancer that destroys tissue by applying extreme cold to it. Liquid nitrogen is usually used.

dysuria: painful urination.

embolization: a treatment that blocks the blood supply to a tumor by injecting a substance into the artery that feeds the tumor. This treatment is usually used in cases of cancer that has spread to many areas, especially if it has metastasized to the liver.

endocrine therapy: a type of treatment that uses medications to alter levels of certain hormones to slow down the growth of tumors. These drugs are usually given orally.

erectile dysfunction: the inability to achieve an erection suitable for sexual activity.

fertility: the ability to reproduce. While it may seem contradictory, some types of cancer treatments may actually increase a man’s fertility. This is especially true for certain types of chemotherapy.

hormone therapy: a type of treatment that uses medications to alter levels of certain hormones to slow down the growth of prostate tumors. These drugs are usually given by injection or IV.

hormones: chemicals produced by the body to control and regulate certain functions. Hormones are produced by endocrine glands and enter the bloodstream, where they travel to different parts of the body and control a specific function. An example of this is thyroid hormone, which regulates the rate at which cells burn energy.

hypertension: high blood pressure.

interstitial implants: a form of treatment where small rods of radioactive material are placed in the area surrounding a tumor to destroy cancer cells.

lithotripsy: the use of sound waves to break up stones in the kidney or urinary tract. This procedure is done in the hospital and requires anesthetics and a general surgeon.

metastasis: the spread of cancer from one part of the body to another, either through the lymphatic system or through blood flow. Metastasis is the leading cause of death in cancer patients.

micturition: the medical term for urination.

nephrectomy: surgical removal of a kidney. This procedure can be done to remove a small tumor or growth from the kidney, or to treat cancer that has spread to the kidney.

non-hodgkin’s lymphoma: a type of cancer that starts in the lymphatic system, which is part of the immune system.

oncologist: a doctor who specializes in treating cancer.

ovarian cancer: a common type of cancer that starts in the ovaries. It is the leading cause of death due to gynecological cancers and the fifth leading cause of cancer deaths in women as a whole.

pathologist: a doctor who specializes in diagnosing diseases, usually by examining biopsies and other samples taken from patients.

plasmapheresis: the process of removing blood plasma and replacing it with a sterile liquid, usually done as a treatment for certain types of cancer.

prostate-specific antigen: a chemical produced naturally by the prostate. Elevated levels can indicate an increased risk of prostate cancer.

relapse: a term used to describe when a patient’s cancer begins growing again after initially stopping or even shrinking. This can happen due to cancer cells that were not detected, or as a result of the patient not following their treatment plan.

risk factors: any factor that increases the risk of developing a certain type of cancer. For example, a risk factor for prostate cancer is age, since the majority of people diagnosed with the disease are over the age of 50. Another risk factor is having a family history of certain types of cancer.

Sources & references used in this article:

Semen quality and reproductive hormones before orchiectomy in men with testicular cancer by PM Petersen, NE Skakkebæk, K Vistisen… – Journal of Clinical …, 1999 – ascopubs.org

Hip fractures in men with prostate cancer treated with orchiectomy by PW Dickman, JAN Adolfsson, K ÅSTRÖM… – The Journal of …, 2004 – Elsevier

Prognostic factors in stage I non-seminomatous germ-cell testicular tumors managed by orchiectomy and surveillance: implications for adjuvant chemotherapy. by P Hoskin, S Dilly, D Easton, A Horwich… – Journal of Clinical …, 1986 – ascopubs.org

Pathologic findings at orchiectomy following chemotherapy for disseminated testicular cancer. by A Greist, LH Einhorn, SD Williams… – Journal of Clinical …, 1984 – ascopubs.org

Spermatogenesis after unilateral orchiectomy for testicular cancer in patients following surveillance policy by KD Jacobsen, L Theodorsen, SD Fossa – The Journal of urology, 2001 – auajournals.org

Comparison of gonadotropin-releasing hormone agonists and orchiectomy: effects of androgen-deprivation therapy by M Sun, TK Choueiri, OPR Hamnvik, MA Preston… – JAMA …, 2016 – jamanetwork.com

Orchiectomy alone in the treatment of clinical stage I nonseminomatous germ cell tumor of the testis. by PC Sogani, WF Whitmore Jr, HW Herr… – Journal of Clinical …, 1984 – ascopubs.org

Comparison of prostatic cancer tissue dihydrotestosterone levels at the time of relapse following orchiectomy or estrogen therapy by J Geller, JD Albert, DA Nachtsheim… – The Journal of urology, 1984 – auajournals.org