Orchidectomy

You might have an operation to remove your testicles (orchidectomy). The testicles produce testosterone, which can help prostate cancer grow. So removing the testicles can help to control the growth of prostate cancer. After removal of the testicles, the level of testosterone in the blood falls quickly. Removing the testicles is not a common treatment. You’re more likely to have injections or tablets to reduce the level of testosterone in your blood.

What is an Orchiectomy and why is it needed?

People often tend to underestimate prostate cancer and its severity. However, there are plenty who overreact without even knowing what they are diagnosed with. Though cancer ultimately affects our daily routine, there are numerous recovery options available against testicular/prostate cancer. While undergoing an orchidectomy is the smartest option, knowing about your disease and diagnosis is equally important. An orchidectomy is one such procedure used widely for the treatment of testicular cancer. Some men prefer to have this surgery as it is one treatment compared to regular injections. Orchidectomy is not reversible. You may find the removal of your testicles upsetting.

Orchiectomy And Its Types

Orchidectomy is a surgical procedure in which either one or both the testicles of the human body are removed. It is performed to treat testicular or prostate cancer. It is a simple operation that requires no longer than 30 minutes under a general anaesthetic. If one testicle is removed during the orchidectomy, then the other remaining testis makes up for all the other testis’ work. Therefore, even after removing one testis from the body, sperm, testosterone production and erectile function are normal There are several types of orchiectomy procedures depending on your condition or the goal that you’re trying to reach by having this procedure done:

How Is Orchiectomy Surgery Performed?

There are three different types of orchidectomy; simple, subcapsular, and inguinal. 

• Simple orchiectomy

The patient lies flat on the operating table while the penis is taped to the abdomen. When you are admitted, the nurse will shave a small area near the groin. After the anesthesia has been administered, the doctor makes an incision through the midpoint of the scrotum while gently piercing through the underlying tissue.  With the incision now completed, the surgeon/doctor proceeds to remove the spermatic cord followed by the testicle(s). Post-surgery, the doctor will close the incision with two layers of sutures, gauze, and medical dressing.

• Subcapsular orchiectomy

Is yet another option performed in the treatment of prostate cancer. A subcapsular orchiectomy is similar to that of a simple orchidectomy but has some minor differences. A subcapsular orchiectomy includes removing the underlying tissue surrounding the testicle instead of the testicle, allowing a nearly normal-looking scrotum.

• Inguinal orchiectomy 

Either unilateral or bilateral. Here, instead of entering through the scrotum, the surgeon makes a minimal cut/incision in the patient’s lower abdominal area. Post incision, the surgeon then proceeds to remove the testicle(s) along with the entire spermatic cord.  Post-surgery, the wounds are covered with multiple layers of sutures and covered using a surgical gauze and bandage. A saline solution is used to cover and close the different layers of skin tissues.

• Radical Orchiectomy 

Radical orchiectomy is a surgical procedure performed in people diagnosed with testicular cancer. In the majority of the cases, only one testicle is involved. However, in less than 5% of cases, men may develop testicular cancer in both their testicles. The purpose of a radical orchiectomy is to remove the testicle when there is a solid and hard mass detected in the testicle.  The removed testicle(s) is then sent to a lab where pathologists examine the tumor under a microscope. After studying the tumour, the pathologists are then able to determine the type and stage of cancer. The term radical means not just the testicle, but the surrounding structures are removed as well as the spermatic cord. Radical orchiectomy is done for suspected testicular cancer. It is usually performed through a small incision in the groin to optimize cancer control How Will The do Surgery Affect You? The removal of one testicle:

• Will have no significant impact on a person’s fertility.
• It Will not affect the sex life.
• It Will not affect testosterone levels.
• Does Not Cause Any Other Health problems.
• It is not noticeable to most people.

What Is Prostate Cancer And How Does It Develop? The prostate is a gland that is located between the urethra and the gallbladder and is responsible for the production of fluid that washes out the semen from the body. The prostate is responsible for fluid production that washes the semen and keeps the sperms healthy for successful fertilization. Prostate cancer is common among older men. Prostate cancer generally develops within the prostate’s edges and is likely to occur in more than one place. However, the tumor cells then multiply, following which the tumor starts moving through the prostate’s inner lining, making it difficult for the body to pass urine or ejaculate quickly. Unlike many cancers, prostate cancer grows slowly, allowing the patient an easy recovery if detected early. What About A Testicular Implant? Removal of one testicle poses a concern for many in terms of appearance. However, most people won’t notice the absence of a testicle. But having just one testicle can have a psychological impact on a young man, causing him to feel embarrassed, self-conscious, or even depressed. When necessary, an implant or a prosthesis can be placed into the scrotum to fill the void left behind by the removal of one testicle.  These implants can either be placed at the time of removal of the testicle or can be placed anytime afterward. These implants come in multiple sizes and different types, including saline-filled, silicone gel, and soft solid implants. The decision to whether to have an implant or not is entirely up to the person undergoing the orchidectomy. Bear in mind that a testicular implant serves no functional purpose and is purely cosmetic. An implant may prove as a psychological benefit to young men.  However, the disadvantage of a testicular implant is that they require additional surgery and carry possible potential risks of infection followed by an additional expense. Post-Surgical Care  An orchidectomy is a quick procedure, and you can go home a few hours after the surgery. However, you have to return for a follow-up the next day. Following your orchidectomy, you will need to take the utmost care for the 1st two weeks. This post-surgical care includes;

• Wearing Scrotal Support For The 1st Two Days.
• Icing To Reduce Swelling Around The Incision Or Rectum.
• Keeping The Area Clean, Dry, And Covered In Gauze.
• Using Creams/Ointments as prescribed by your medical practitioner.
• Advil, Motrin for the pain as prescribed by your medical practitioner.
• Stool Softener ( Only For 15 Days) and high-fiber diet for regular and strain-free bowel movements.

Most patients undergo regular follow-up exams for 5-10 or more years. These exams generally include:

• Period Assessment by doctors.
• Tumour Markers.
• Chest X-Ray and CT Scan.

 

Symptoms

There are usually no symptoms in the early stages of prostate cancer. However, as the tumour enlarges the prostate, you may start experiencing the following symptoms:

• Difficult in urination
• Weak, interrupted, or painful urination
• Frequent urination
• Painful Ejaculation
• Problems getting an erection
•  Blood in urine or semen
• Pain or stiffness in the lower back, hips, or pelvis

NOTE: These symptoms may also be caused by prostate enlargement, which is not cancer.

.Your doctor may do this surgery to treat breast cancer or prostate cancer. Without the testicles, your body can’t make as much testosterone. Testosterone is a hormone that can cause prostate or breast cancer to spread more quickly. Without testosterone, the cancer may grow at a slower rate, and some symptoms, such as bone pain, may be more bearable.

Your doctor may recommend orchiectomy if you’re in generally good health, and if the cancer cells have not spread beyond your testicles or far beyond your prostate gland.

You may want to do an orchiectomy if you’re transitioning from male to female and want to reduce how much testosterone your body makes.

Causes

Prostate cancer, testicular tumor, cryptorchidism, and testicular torsion were the first four causes of orchiectomy.

FAQ

How Long Does It Take To Recover After An Orchidectomy?

The recoveries are quick. The skin heals within two weeks, but the deeper layers take up to three months. Therefore, complete wound healing takes around six to eight weeks to recover. Once the catheter is removed from the body, there will be some urinary leakage, which will gradually come under control 4-6 weeks after the surgery.

What are Orchiectomy side effects & Orchiectomy complications?

Because the prostate sits in the urinary tract and because the nerves that allow for erection are attached to the prostate, patients will experience some urinary side-effects and a few difficulties with erection. The main side effect is urinary leakage, which is most often temporary, and erectile dysfunction. If the urinary leakage is severe, it can be fixed with a small operation called the artificial sphincter.

If you see the following side-effects, see your doctor immediately:

• Pain around the incision
• Pus from or around the incision
• High Fever (Over  100 F)
• Problems In Urination

How Much Does An Orchidectomy Cost?

The cost of an orchidectomy generally ranges from Rs 3,75,000 to Rs 5,30,000

What are some other treatment options against Prostate Cancer?

Testicular/Prostate cancer can be cured with modern therapy. The ability to treat and cure cancer is one of the remarkably encouraging stories in all of medicine

 

Possible treatments may include:

• Surveillance Only meaning no further treatment but closely monitoring cancer with lab tests and imaging 
• Chemotherapy
• Radiotherapy
• Further Surgery