Orchiectomy is a surgical procedure that removes one or both testicles. Healthcare professionals use orchiectomy to treat testicular cancer, prostate cancer, and male breast cancer.
Transgender women may also choose orchiectomy before undergoing gender affirming surgery.
Keep reading to learn more about orchiectomy, including what to expect from the process, the risks, and the efficacy of the surgery.
A healthcare professional may also recommend orchiectomy to treat:
- an undescended testicle after puberty
- severe trauma to the testicle
- testicular torsion, which occurs when the spermatic cord becomes twisted, restricting blood supply to the testicle
There are several different types of orchiectomy procedure. These include:
During simple orchiectomy, a surgeon will remove one or both testicles and a portion of the spermatic cord through a small incision in the scrotum.
Depending on the person’s preference, the surgeon can insert a prosthetic testicle before closing the incision.
Bilateral orchiectomy removes both testicles.
Subcapsular orchiectomy is a testis-sparing procedure that only removes the tissue surrounding the testicles.
Radical inguinal orchiectomy
Radical inguinal orchiectomy is the recommended treatment for testicular cancer. During this procedure, a surgeon will remove the testicle, spermatic cord, and tumor through a small incision below the abdomen.
A healthcare professional can also use radical inguinal orchiectomy to
Before orchiectomy, a person will undergo a physical examination wherein they will give blood and stool samples. A healthcare professional will determine whether or not the person is healthy enough to participate in orchiectomy based on these examination results.
A person should provide a healthcare professional with the following information before the procedure:
- a list of all medications and supplements they are currently taking
- any known or suspected allergies to anesthetics or other medications
- whether or not they want to have a prosthetic testicle implanted during the operation
Individuals who wish to undergo orchiectomy as part of their male-to-female transition will need a medical clearance letter from their primary doctor. This letter states that the individual can give consent to participate in the operation. It also indicates that they are physically prepared for the procedure.
Once a person receives authorization to undergo orchiectomy, a healthcare professional will provide detailed instructions about preparing for the surgery. They will also explain how long the surgery will last and what to expect afterward.
A healthcare professional may instruct the person to limit their food and drink intake during the hour immediately before the procedure.
Before the procedure, the person will receive either a general or a local anesthetic. People should not drive or operate machinery until the effects of the anesthetic wear off, so they should arrange for a ride home after the surgery.
First, the surgeon will tape the penis to the abdomen. They will then sterilize the incision site and surrounding skin. The surgeon will make an incision either on the scrotum (for simple orchiectomy) or on the lower abdomen (for radical inguinal orchiectomy).
The surgeon will then apply clamps to the spermatic cord to minimize blood loss. They will then remove one or both testicles through the incision. Depending on the type of orchiectomy a person is undergoing, the surgeon may also remove the spermatic cord or the tissue surrounding the testicles, along with any tumors.
Depending on the individual’s specifications, the surgeon may replace the testicle with a silicone prosthesis. After removing the clamps, they will sterilize the wound and close the incision with sutures.
When an orchiectomy procedure occurs on an inpatient basis, the person will go to a recovery room, where a doctor or nurse will monitor their recovery. They will likely stay in the hospital overnight.
When an orchiectomy procedure occurs on an outpatient basis, the person can go home within a few hours. However, they will need to return for a follow-up so that a healthcare professional can evaluate their recovery.
People may experience some discomfort and soreness after an orchiectomy procedure. They should notify a healthcare professional if the pain is severe.
According to the Urology Care Foundation, it can take 2–8 weeks to fully recover from an orchiectomy procedure.
A healthcare professional will provide detailed instructions about the recovery process. These instructions can include:
- wearing a scrotal support strap for the first 2 days
- using ice packs to reduce swelling
- keeping the incision clean and dry
- taking ibuprofen or another nonsteroidal anti-inflammatory drug for pain and swelling
- avoiding strenuous physical activity, such as lifting heavy objects and running
Healthcare professionals use orchiectomy to treat testicular, prostate, and breast cancer in males. Transgender women can also elect to participate in orchiectomy as part of their male-to-female transition.
There is a less-than-5% chance of testicular cancer reoccurring or spreading to the other testicle after orchiectomy.
According to one 2020 study, orchiectomy and hormone therapy achieve treatment results for metastatic prostate cancer. However, the study authors state that orchiectomy is a more cost effective option.
The researchers behind another 2020 study examined the physical and psychological effects of subcapsular orchiectomy, total orchiectomy, and hormone treatment in people with metastatic prostate cancer.
Compared with the participants who underwent total orchiectomy, those who underwent subcapsular orchiectomy had fewer instances of post-traumatic stress disorder (PTSD) and phantom testis syndrome.
The participants in the subcapsular orchiectomy group also reported higher satisfaction and quality of life than those in the total orchiectomy group.
The subcapsular orchiectomy and hormone therapy groups had similar outcomes for PTSD, treatment satisfaction, and quality of life.
As with any surgical procedure, orchiectomy does come with a risk of post-operative side effects and complications.
Some potential side effects associated with orchiectomy include:
- loss of muscle mass
- hot flashes
- decreased sexual interest
- gynecomastia, or breast enlargement
Some potential complications associated with orchiectomy include:
- extensive bruising
- blood clots
- hemorrhaging, or internal bleeding
- erectile dysfunction
Orchiectomy is a safe and effective treatment for testicular cancer, prostate cancer, and male breast cancer. Transgender women can also elect to undergo orchiectomy as they transition from male to female.
Orchiectomy is a surgical procedure that removes one or both testicles. Depending on the type of orchiectomy a person undergoes, a surgeon may also remove the spermatic cord and the tissue surrounding the testicles.
If a person undergoes orchiectomy to treat cancer, they can choose to have a prosthetic testicle implanted during the operation.