What is Orchiectomy ?!

Orchiectomy is the surgery to remove one or both testicles. The testis is the male organ that is responsible for producing sperm and male testosterone. Testicular resection is a common treatment for testicular cancer or other conditions such as prostate cancer. Testicular resection, which is performed to treat testicular cancer, is called a radical radicular orchiectomy. The radical name is that the entire testicular ligament and the testicle itself are removed. This is called an inguinal operation because the testicle is removed through a small incision made in the lower abdomen (groin).

To treat cancer or other testicular problems, removing one or both testicles is necessary. If the patient has prostate cancer and cancer has spread to other parts of the body, testicular surgery is performed. Prostate cancer cells need testosterone to grow, so if both testicles are removed, the amount of this hormone in the body will decrease. As testosterone levels drop, prostate cancer grows slowly and eventually stops or shrinks from several months to several years. If cancer has also spread to the bones, the removal of the testicles and a decrease in testosterone will slow down the growth of cancer in the bones and the patient will suffer less pain. In case of severe damage to one or both testicles, orchiectomy should be performed. Severe testicular infection, a congenital defect called testicular torsion that interrupts blood flow to the testicles or the testicle does not descend and is not located in the scrotum, is a rare cause that necessitates testicular resection.

Testicular resection is performed in the event of certain cancer complications, such as testicular cancer, breast cancer, or prostate cancer, or to prevent undeveloped testicles during puberty. Testicular resection is recommended for the treatment of noncancerous or benign lesions, such as testicular damage, or for patients who wish to undergo gender reassignment surgery.

Here are the different types of testicular resection :

Inguinal radical orchiectomy

In radical inguinal orchiectomy, the testicles and spermatic cord are removed through an incision made in the groin. Sometimes a testicular prosthesis filled with saline solution is placed in the scrotum.

Simple orchiectomy

The surgeon removes the testicle from the scrotum and replaces it with a testicular prosthesis. In both simple and radical operations, one or both testicles can be emptied. If both testicles are removed, it is called a bilateral orchiectomy.

Subcapsular orchiectomy

In this operation, the inner lining of the testicular gland is emptied and the testicle remains in place.

After confirmation of the diagnosis, a CT scan of the abdomen and pelvis is performed. If the testicular prosthesis is to be inserted into the scrotum, cefazolin is injected intravenously at a rate of one gram thirty to sixty minutes before the incision is made.

Postoperative care at home

• Do not forget the ice pack.
• Use a suspensor.
• Time to call a doctor

The surgeon makes the incision 2 cm above the inguinal ligament and parallels it, along the line connecting the outer rings to the inside. If the testicular mass is so large that it cannot be removed through the incision, the surgeon will extend the incision from the scrotum. Surgery is performed at a hospital or surgery center. Most testicular resection surgeries are performed under local or regional anesthesia so that the patient does not feel pain during the operation and is conscious at the same time. The patient also receives sedatives. The doctor makes incisions in the groin and removes the testicles through these incisions. The incisions are finally sutured. If the patient wishes, the saline-filled prosthesis can be placed in the scrotum instead of the testicle so that the scrotum looks and feels normal. Surgery usually takes about an hour.

The patient is monitored in the recovery ward for a few hours after surgery and then discharged. The patient should carefully follow the doctor’s instructions for keeping the wound clean and dry and wash the hands before and after handling the wound. The patient should wear comfortable and loose clothing so that the incisions are not irritated. Daily activities usually resume within one to two weeks and complete recovery is achieved after two to four weeks.

• Duration of the recovery period
• Activities such as lifting objects are forbidden during recovery.
• Take care of yourself at home
• Symptoms or problems that may occur after surgery and methods of managing these complications
• Time to return to the office

Be sure to contact your doctor if you experience any of the following

• Fever above 38.3 ° C
• Redness or swelling of the groin
• Swelling of the scrotum
• Having a surgical wound
• Inability to urinate
• Any questions or concerns.

After the removal of the testicles, like any other surgery, there are several possible complications, some of which are caused or exacerbated by the removal of both testicles. Possible complications and risks associated with testicular resection are:

• Reaction to anesthesia
• Bleeding
• Infection
• blood clotting
• sterility
• Erectile dysfunction
• Groin or genital anesthesia
• Decreased libido
• Depression, mood swings, and hot flashes
• Muscle analysis
• Osteoporosis
• Breast enlargement (gynecomastia)
• Weight Gain
• Chronic fatigue
• Dissatisfaction with yourself