Who Needs an Orchidectomy Procedure?

An orchidectomy (also called orchiectomy) is recommended for individuals in specific medical situations, including:

• Testicular cancer
• Prostate cancer
• Severe testicular trauma
• Chronic infections
• Gender affirmation surgery
• Benign testicular tumors or conditions

Key Takeaways of Orchidectomy

• Type of Procedure: Surgical (Orchidectomy)
• Duration: About 30 minutes to 1 hour
• Anesthesia Used: General or spinal anesthesia
• Recovery Time: Return to light activities within 1 to 2 weeks; full recovery in 4 to 6 weeks

Types of Orchidectomy

• Simple Orchidectomy: Removes one or both testicles via an incision in the scrotum. Used for gender affirmation, chronic pain, or infections.
• Radical Orchidectomy: Removes the testicle, spermatic cord, and surrounding structures through a groin incision. Primarily performed to treat testicular cancer.
• Subcapsular Orchidectomy: Removes only the inner glandular tissue of the testicle, leaving the outer structure intact. Commonly used for advanced prostate cancer to reduce testosterone while preserving scrotal appearance.

Indications of Orchidectomy Surgery

Orchidectomy surgery, also known as orchiectomy, is performed for various medical and personal reasons. The procedure involves the surgical removal of one or both testicles. Here are the main indications of Orchidectomy:

• Testicular Cancer: A radical orchiectomy is often the first step in treating testicular cancer by removing the cancerous testicle.
• Gender Affirmation Surgery: Performed as part of the transition process for transgender women to reduce testosterone and align with gender identity.
• Advanced Prostate Cancer: Reduces testosterone production to slow cancer progression.
• Testicular Trauma: Severe injuries may require removal to prevent complications like infection or chronic pain.
• Severe Infections: Orchitis (testicle inflammation) or epididymitis (epididymis inflammation) may necessitate removal if unresponsive to treatment.
• Chronic Pain: Persistent testicular pain (orchalgia). Unresponsiveness to other treatments may lead to removal.

Benefits of Orchidectomy

• Cancer Treatment: Removes cancerous testicles, effectively managing testicular and prostate cancers.
• Hormonal Control: Reduces testosterone production, slowing the progression of hormone-sensitive conditions like advanced prostate cancer.
• Chronic Pain Relief: Provides relief from chronic testicular pain (arthralgia) resistant to other therapies
• Infection Management: Prevents complications from severe infections like orchitis or epididymitis.
• Gender Affirmation: Helps transgender women in their transition by decreasing testosterone levels, assisting in both physical and emotional alignment.
• Trauma Management: Addresses complications from severe testicular injuries to prevent further damage or infection.
• Improved Quality of Life: Resolves underlying medical issues, reducing discomfort and improving overall well-being.

Preparing for Orchidectomy Surgery

Preparing for an Orchidectomy surgery involves several steps to ensure you are physically and mentally ready for the procedure and the following recovery period. Here's a guide to help you prepare:

• Consultation: Meet with your urologist to discuss your medical history, medications, allergies, and any concerns you may have.
• Medical Evaluation: A thorough health assessment ensures that you are fit for surgery.
• Tests: Blood tests, imaging (such as ultrasound or MRI), and other diagnostic tests may be required.
• Stop Smoking: Quit or reduce smoking to aid healing and reduce complications.
• Medication Adjustments: Follow the instructions for stopping or adjusting your medications.
• Fasting: Fast as instructed to ensure safety during anaesthesia.

Procedure Steps in Orchidectomy(Orchiectomy) Surgery

The procedure is performed for various reasons, including treating testicular cancer, hormone-related conditions, and gender affirmation surgeries. Here's an overview of what happens during an Orchidectomy surgery:

• Preoperative Evaluation: Before the surgery, a thorough evaluation is conducted to determine the patient's medical history, overall health, and the specific reason for the procedure. The surgeon will discuss the procedure, potential risks, benefits, and alternatives with the patient.
• Anesthesia: Orchidectomy is typically performed under general anaesthesia, ensuring that the patient is asleep and comfortable throughout the procedure.
• Testicle Removal: The surgeon gently separates the testicle from its attachments, including the spermatic cord and blood vessels. In a simple or subcapsular orchiectomy, the testicle is removed, leaving the tunica albuginea (the tissue covering the testicle) intact. In a radical orchiectomy, the entire testicle, including the tunica albuginea, is removed.
• Lymph Node Examination (if applicable): For testicular cancer cases, lymph nodes in the groin area might be examined and, if necessary, removed to determine if the cancer has spread.

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Recovery After Orchidectomy Surgery

Recovery after an Orchidectomy surgery, orchiectomy, is a crucial phase that requires proper care and attention to ensure a smooth healing process. The recovery timeline can vary based on the type of surgery, individual health, and the reason for the procedure. Here's what you can expect during the recovery period:

• Wound Care: Keep the surgery site Clean and dry surgery site; follow care instructions
• Pain Management: Use prescribed or approved pain relievers as directed.
• Activity Restrictions: No heavy lifting or straining; gradually return to light activities at your level of comfort.
• Follow-Up: Attend all follow-up appointments to check the healing.
• Swelling & Bruising: Common, but should decrease over time.
• Driving: Avoid driving until cleared, especially if taking pain medications.

Lifestyle Changes After Orchidectomy Surgery

Lifestyle changes after Orchidectomy surgery, which involves the removal of one or both testicles, may vary based on the individual's circumstances, the reason for the surgery, and personal preferences. Here are some potential lifestyle changes to consider:

• Hormone Management: Discuss hormone replacement therapy (HRT) if both testicles are removed to maintain hormone balance.
• Sexual Health: Hormonal changes may affect desire and function. Communicate with your partner and healthcare provider.
• Emotional Well-being: Seek support from therapists or support groups for issues related to body image, self-esteem, or emotional adjustment.
• Physical activity can improve both mood and health. Consult your doctor before starting any routine.
• Diet: Maintain a balanced diet to support recovery and overall health.
• Follow-ups: Regular medical check-ups to monitor your health and recovery.

Complications of Orchidectomy

• Infection at the surgical site
• Bleeding or hematoma (blood collection under the skin)
• Pain or discomfort in the groin or scrotum
• Swelling or bruising post-surgery
• Scrotal or wound infection
• Psychological impact, especially with bilateral Orchidectomy (loss of testicles)
• Hormonal imbalance or low testosterone levels, particularly if both testicles are removed
• Fertility issues, especially with the removal of both testicles

Most complications are rare and can be managed with proper medical care. Always follow your doctor's advice for recovery.