Adjusting to life after an orchiectomy can differ for each person. Although a person may feel relieved after treatment, they may have concerns about the long-term side effects of the surgery.

An orchiectomy is surgery to remove one or both testicles. People will usually have orchiectomy for any type and stage of testicular cancer.

This article examines what to expect with orchiectomy, survival rates, and potential long-term effects.

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After undergoing an orchiectomy, a person may have concerns about certain aspects of their life, such as their fertility, sexual health, and body image.

Many people can go back to their normal after curing testicular cancer, which can include having satisfying sex and supportive relationships. If a person does experience any side effects on their sexual health, they can speak with a doctor to discuss possible treatment options.

For some people, the removal of one or both testicles may affect body image and mental health. A person can talk with a doctor about dealing with changes to how they look and treatment options.

Physical and sexual health

Orchiectomy may cause temporary or permanent infertility. Before having treatment for testicular cancer, people may want to consider sperm banking if they wish to have biological children in the future.

According to the American Cancer Society (ACS), surgery to remove one testicle will not usually affect sex or erectile function. This is because the remaining testicle will pick up the functions of the testicle that was removed.

The removal of both testicles causes infertility, as the body can no longer produce sperm. Removing both testicles can reduce testosterone levels, which may reduce sex drive and erectile function. Low testosterone may cause:

  • fatigue
  • loss of muscle mass
  • hot flashes
  • alterations in mood and motivation

Testosterone supplements may help prevent these side effects.

Mental health and body image

After an orchiectomy, some people may have concerns about body image and difficulties adapting to how they look. After surgery, the scrotum will look and feel empty.

If this is a concern for people, they can talk with a doctor about treatment options. One option is a testicular prosthesis, which is an implant in the scrotum that replicates the appearance of a testicle.

An orchiectomy is an effective treatment option for testicular cancer.

Seminoma

According to a 2019 study of 11,206 people, stage 1 seminoma is one of the most curable male cancers. After orchiectomy, survival rates are around 99%.

In a 2018 study of 1,564 cases of seminoma after orchiectomy, the overall survival rate was 98% at 5 years.

Nonseminomatous germ cell tumors

According to a 2019 study, stage 1 nonseminoma germ cell tumors (NSGCT) are one of the most curable cancers, with an overall 10-year cancer-free survival rate of around 99%.

A 2018 study examined the survival rates in 1,086 cases of NSGCT after orchiectomy. The overall survival rate was 96% at 5 years.

A person’s healthcare team will provide them with instructions on how to care for themselves after the surgery.

According to the United Kingdom’s National Health Service, the day after surgery, people may be able to get up, walk around, and go home. They can take painkillers for any pain or discomfort.

People can bathe 48 hours after surgery but must dry the wound gently. They should also avoid heavy lifting and strenuous exercise for 2 weeks after surgery.

People may be able to return to driving and work when they feel physically and emotionally able to.

Follow-up appointments

After an orchiectomy, people will have follow-up appointments. According to the Canadian Cancer Society, these usually occur every 2 to 6 months for 3 years following the initial treatment.

After the first 3 years, people may have checkups every 6 to 12 months. Follow-ups may continue for 5 to 10 years after the initial treatment. These checkups may include:

  • physical examination to check the remaining testicle and lymph nodes in the groin, abdomen, and chest
  • checking pulse and blood pressure
  • listening to the lungs
  • blood tests to check tumor marker levels
  • chest X-rays in case cancer has spread to the lungs
  • CT scans of the pelvic area and abdomen to check if any cancer remains or if it has spread

People will need to contact a doctor if they experience any complications after orchiectomy, such as:

  • bleeding
  • infection
  • excessive bruising
  • seroma, which is a buildup of fluid after surgery
  • numbness or pins and needles in the surrounding area
  • increased risk of inguinal hernia

In most cases, wound complications will resolve without needing treatment, but severe complications may require medical treatment.

People can also contact a doctor if they are experiencing any physical or mental health issues after an orchiectomy, such as sexual health issues or concerns around body image.

The following are commonly asked questions about life after an orchiectomy.

What is the life expectancy for testicular cancer?

According to the ACS, the 5-year relative survival rate for a testicular cancer diagnosis between 2012 and 2018 for all stages combined is 95%.

According to a 2018 study, the overall 10-year survival rate for seminomas and NSGCTs is 96%, and the cancer-specific survival rate is 98%.

What are the chances of getting testicular cancer again?

According to a 2023 study, 81 out of 360 people with initial stage 1 germ-cell testicular cancer experienced a relapse after a follow-up of approximately 47 months. The authors state that this aligns with other studies, which suggest a relapse rate of 15% to 50%.

However, the authors also state that those who relapse have excellent survival outcomes.

Monitoring can help to detect recurring testicular cancer quickly, resulting in excellent survival.

What are the disadvantages of having one testicle removed?

Removal of one testicle will usually not have any impact on a person’s sex life, erectile function, or fertility.

However, it may have an effect on how a person feels about the way they look. If this is affecting a person’s confidence, mental health, or relationships, people may want to talk with a doctor or mental health professional.

There is a small risk of testicular cancer developing in the remaining testicle, so it is important to be aware of any symptoms.

In most cases, people with testicular cancer will have an orchiectomy to remove one or both testicles.

Testicular cancer is highly curable, particularly in the early stages. Orchiectomy may affect sexual health, fertility, and body image, so it is important to discuss any concerns with a doctor.