Orchiectomy (also known as orchidectomy) is a surgical procedure in which one or both (bilateral orchiectomy) of the testicles are removed, usually to treat testicular cancer or prostate cancer.
Because of the nature of testicular cancer, a standard biopsy for the purpose of diagnosis is not possible as the procedure can further spread the cancer. If testicular cancer is suspected then removal of the testicle is required.
Orchiectomy may also be a form of hormone treatment for patients with prostate cancer, performed to decrease the levels of the male hormone testosterone in the male body. Testosterone can promote prostate cancer growth.
Orchiectomy may also be required to treat male breast cancer, post-puberty undescended testicles, and non-cancer related injuries like trauma or gender reassignment surgery.
There are two major types of orchiectomy:
Simple Orchiectomy – This is where the testis is removed through a small incision in the scrotum. If both testicles are removed it is called a bilateral simple orchiectomy. A prosthetic testicle implant can be inserted. This is usually performed to treat advanced stage prostate cancer or if the testicle has infarcted (died) due to either infection or torsion (twisting).
Radical Inguinal Orchiectomy – This is where the testis and spermatic cord are removed through a small incision in the groin. A prosthetic testicle implant can be inserted. This is most common when testicular cancer is suspected.
After surgery you can expect mild to moderate pain for a few days. You will be prescribed painkillers. Swelling at the surgical site is normal and will go down after a few weeks.
Orchidectomy is usually a day procedure. Once home patients are advised to refrain from strenuous activity like heavy lifting and sport for four weeks. Speak with your doctor about when you can return to work and resume sexual activity.
If you had a bilateral orchiectomy, you will start to see changes in your body. This may include decreased sex drive, erectile dysfunction and weight gain. This can be quite distressing for some patients – be sure to seek help from your doctor for advice about dealing with these changes.
As with any surgical procedure, there are some risks involved with orchiectomy, including bleeding and infection at the surgical side.
Side effects from the procedure are caused by the absence of hormones produced by the testicles, such as testosterone. Depending on the surgery, side effects will vary.
These include infertility, erectile dysfunction, decreased sex drive, hot flashes, depression and mood swings, weight gain and breast enlargement, and a loss of muscle mass.Again, speak with your doctor about how you can help manage these side effects.
Dr Arianayagam is an expert in the field of urological cancer surgery, including robotic surgery and laparoscopic surgery for the treatment of testicular cancer. He is widely considered one of the top urological oncologists in Australia.
If you have any further questions about orchiectomy and would like to book an appointment, please feel free to call.