The Testicle Removal (Orchiectomy) procedure involves the surgical removal of one or both the testicles. A Testicle Removal procedure involves the scrotum, the testicle(s), the spermatic cord, vas deferens, related nerves and blood vessels.

Why is the Testicle Removal surgical procedure performed?

• The Testicle Removal procedure is performed as an aspect of a definitive treatment of testicular, prostate, or male breast cancer.
• All of these cancers are testosterone-dependent (hormone released from the testicle) the testicles are responsible for the production of testosterone.
• Thus, removing the testicle(s) reduces the hormone production, thereby reducing the effects of the tumor and metastasis.
• It is also performed in cases of gender change or reassignment and testicular necrosis (due to decreased blood flow following untreated torsion testis).

How is the Testicle Removal surgical procedure performed?

There are 3 types of Orchiectomy procedure:

Simple Orchiectomy:

• It is performed for gender change as well as palliative treatment for advanced cancer
• An incision is made in the mid-point of the scrotum and the surgeon cuts through the underlying tissue
• The testicle and parts of the spermatic cord are removed through the incision, and it is closed with the help of sutures and covered with a dressing
• A prosthetic testicle can be inserted to give the appearance of a normal scrotum

Subcapular Orchiectomy:

• It is performed in the treatment of prostate cancer
• It is similar to the above method except that in this procedure the glandular tissue is removed from the lining of each testicle, rather than removing the entire testicle itself
• This method keeps the appearance of the scrotum normal  
• Inguinal Orchiectomy:
• It is also called Radical Orchiectomy and is performed, when testicular cancer is suspected. It can be performed on either one or both the testicles
• An incision is made in the groin area, the testicle as well as the entire spermatic cord is removed (testicular cancer spreads to the kidneys via the spermatic cord)
• The different layers of skin are then sutured back and the wound is covered with appropriate dressing

What Tests are needed, before the Testicle Removal surgical procedure?

The following tests are required by the physician before the Testicle Removal procedure:

•    X-rays

•    CT scan

•    Ultrasound scan

•    ECG

•    Routine blood tests

•    Routine urine examination

What are the possible Risks and Complications during the Testicle Removal surgical procedure?

There are general factors that increase the risk of getting complications during surgery and they include:

• Obesity: Generally greater the degree of obesity, greater is the surgical risk
• Smoking: Longer the smoking history (in pack years smoked), greater the surgical risk
• Advancing age
• Poorly controlled diabetes, as evidenced by a high hemoglobin A1c and a high fasting glucose
• Poorly functioning kidney, as evidenced by increased BUN (blood urea nitrogen) and blood creatinine
• Poorly functioning liver, as evidenced by increased blood liver function tests
• Hypertension (increased blood pressure), especially if it is poorly controlled
• Poor nutritional status (malnutrition with mineral and vitamin deficiencies)
• Poor lung function, as evidenced by abnormal lung function tests
• History of bleeding disorders
• Longstanding illness, such as autoimmune disorders, chronic infections
• Poor immune system due to a variety of causes

The possible risks or complications that may arise during the surgery are:

• Excessive bleeding
• Inadvertent injury to other parts
• Infection
• Anesthetic complications