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Procedure Name

Orchiectomy
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Surgery Type

open
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Hospital Stay

Nil (Outpatient)
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Duration of Surgery

30 to 60 minutes
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Type of Anaesthesia

General Anesthesia
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Full Recovery

2 months

Overview

Orchiectomy (orchidectomy) is a surgical procedure to remove one or both testicles in a male. Orchidectomy is done with the aim of preventing and treating testicular cancer or treating male breast cancer and prostate cancer. Orchiectomy is also performed in transgender women when transitioning from male to female. Orchiectomy is usually done as an outpatient procedure and does not require a stay in the hospital.

What is an Orchiectomy?

A surgical procedure to remove one or both testicles is called Orchidectomy or Orchiectomy. The testes (singular = testis) are a pair of ovoid male reproductive organs outside the abdomen in the scrotum (the sac that holds the testis). Testes produce sperm (male reproductive cells that can fertilize a female egg) and the male reproductive hormone called testosterone. Testosterone causes cancer to grow and spread faster (metastasis); hence the removal of testes is done. During the procedure, the penis (male sex organ present externally on the body) and the scrotum are left intact. Orchiectomy is an outpatient procedure, meaning you can go home the same day.

When is an Orchiectomy Recommended?

An orchiectomy is indicated in the following cases:

  • Treatment of Cancers- Orchiectomy is performed to treat and/or prevent:
    • Testicular Cancer: Orchiectomy is done to diagnose and treat testicular cancer. Male sex hormones (testosterone) encourage the growth of the cancer cells. The production of hormones and cancer progression will be stopped by removing the testes.
    • Male Breast Cancer: Your testes produce the hormone testosterone responsible for the growth and spread of breast cancer in men. Removal of the testes blocks the production of testosterone.
    • Prostate Cancer: The prostate gland (below the bladder in males) produces the seminal fluid (the fluid that carries the sperm). Stopping the production of testosterone through orchiectomy helps in treating prostate cancer.
  • Transgender surgery (Gender reassignment surgery)- in Mysuru Both the testes are removed during a gender reassignment surgery while transitioning a male into a female.
  • Injury to the testis- During an accident, when there is an injury to the testis, an orchiectomy is done as an emergency procedure.
  • Torsion of the testis: This is an emergency condition in which the testis becomes red, swollen, and very painful to touch. It occurs when the tissues surrounding the testis are not completely attached, causing it to rotate. This, in turn, causes the spermatic cord (tube-like structures that support the testis in the scrotum) to twist, leading to the cutting off of the blood supply to the testis. As a result, there is death of the tissue and damage to the testis.

How to Prepare For an Orchiectomy?

Orchiectomy is performed as an outpatient procedure in the hospital. Before undergoing the procedure, there are a few things that you should know. A urologist in Mysuru(a doctor specializing in diseases of the male reproductive tract and the urinary system) will perform the procedure.

  • Your surgeon will discuss your medical history, the current medications that you are taking, and any history of allergies.
  • Your doctor will discuss the procedure for orchiectomy and help you understand the benefits and risks involved.
  • You will need to undergo routine tests, such as blood and urine tests, to assess your general health condition and test for any cancer indicators.
  • You will be advised to stop some medications (like blood thinners to prevent bleeding during and after the surgery ) or to adjust the dosage of other medications a few days before your procedure.
  • You will be advised to avoid smoking and consuming alcohol a few days before the surgery to improve healing post-operatively.
  • You must avoid food or water 8 to 10 hours before the surgery.
  • Orchiectomy can be done under local or general anesthesia. In cases where general anesthesia is used, you must arrange for a family member or a friend to drive you back home.
  • You will be counseled on what to expect after the surgery, mainly about sexual changes. Sperm banking (a method of freezing and storing sperm for prolonged periods) may be advised if you wish to have a child after the procedure.

How is an Orchiectomy Performed?

Orchiectomy is a daycare procedure that takes 30 to 60 minutes and is performed by a skilled urologist. Your surgeon may remove one testicle (unilateral orchiectomy) or both testicles (bilateral orchiectomy) according to your condition. Bilateral orchiectomy is done in t prostate cancer, breast cancer, or as part of a gender transitioning surgery in Mysuru.

On the day of the procedure:

  • You will be asked to shower before coming to the hospital.
  • You will be asked to sign a consent form that allows your doctor to perform the procedure on you.
  • You will have a fitness check-up with the anesthetist before going ahead with the procedure.
  • Your groin area will be cleaned, and the hair overlying the skin will be shaved.
  • You will need to change into a hospital gown and will be wheeled into the operation theatre (OT) and asked to lie supine (on your back) on an examination table. Orchiectomy can be done under general anesthesia or local anesthesia. 
  • If the procedure is done under local anesthesia, the area around the testis will be numbed by the anesthetic drug. 
  • Your vital signs, such as breathing rate, body temperature, and blood pressure, will be checked. An intravenous line (IV line) will be established in your arm for administering fluids and anesthetic drugs. Read on to understand the different types of orchiectomy.

Types of Orchiectomy

3 types of orchiectomy procedures can be done, depending on your condition.

Simple Orchiectomy

In this procedure, the surgeon makes a small incision in the scrotum, and through it one or both the testicles are removed. This is done when you have prostate cancer or breast cancer or to limit the amount of testosterone produced by your body.

  • After anesthesia had been administered, your surgeon will lift your penis and tape it to the abdomen for clear access to the operating site.
  • The surgeon will make an incision on the midpoint of the scrotum, and the deeper layers of tissue will be cut.
  • The spermatic cord will be identified and clamped to minimize bleeding. The spermatic cord is a collection of nerves, vessels, and ducts that supply blood to the testis and also facilitate the passage of semen 
  • Then testes (both) are identified and removed, and the wound is closed with sutures and dressing is applied.
  • The surgeon may replace your testicles with an artificial testis (silicone prosthesis) to retain the normal appearance of the scrotum (after discussing with you). This procedure can be done once the area has healed completely. 

Subcapsular Orchiectomy

This procedure is a variant of simple orchiectomy.

  • Subcapsular orchiectomy is done to treat hormone-dependent prostate cancer. 
  • During this procedure, the testis is spared, and only the tissue surrounding the testicle is removed. 
  • This is usually done to maintain the normal appearance of the testes. 

Also Read: Urology

Radical or Inguinal Orchiectomy

This method is recommended for diagnosing and treating testicular cancer. This procedure is done if a lump in your testis may be cancerous. In radical orchiectomy, the testicle, the spermatic cord, and the tumor are all removed by making an incision in the lower abdomen area instead of your scrotum

  • After anesthesia has been administered, your surgeon will lift your penis and tape it to the abdomen for clear access to the operating site.
  • The surgeon will make an incision in the groin (pubic area) and cut the deeper layers to reach the testis.
  • The spermatic cord will be identified and clamped to minimize bleeding.
  • One or both the testicles with the spermatic cord will be removed through the incision
  • The surgeon will leave a long non-absorbable suture in the stump of the spermatic cord (if repeat surgery is required).
  • After the surgery is completed, the clamps are removed, and the incisions are closed with sutures, and the wound is covered with a sterile dressing.

What to Expect After an Orchiectomy?

After the procedure, you will be sent to the recovery room for a few hours until the effect of the anesthesia wears off. Your vital signs, such as body temperature, pulse rate, respiratory rate, heart rate, and blood pressure, will be monitored. The incision site will be checked for any bleeding or oozing.

At the Hospital

  • You will be given medications for pain and to reduce nausea if needed.
  • If general anesthesia was given, you will be put on intravenous fluids until you pass gas. You can slowly start with liquid food and gradually resume a normal diet.
  • You will be encouraged to walk around early as this helps prevent blood clot formation.
  • You will be given scrotal support or pants to keep the dressing secure.
  • Once your vitals are stable, you can ambulate, eat well, and have normal bowel movements, and you will be allowed to return home.
  • You will be advised to return for the checkup with your surgeon the next day after your surgery.
  • Your surgeon will advise you on the medications and provide home wound cleaning and dressing instructions.

At Home

  • You may have swelling, pain, and bruising over the incision site, which usually will subside within a few days with medications. Apply ice packs to the scrotum for the first two days to reduce the swelling. Do not apply ice directly on the wound, as it may cause an ice burn. Take ice cubes and keep them in a plastic bag. Wrap a towel on the plastic bag and then apply it.
  • You will be asked to wear tight-fitting underwear to support the scrotum to prevent heaviness, pain, and injury (use a jockstrap) 
  • Keep the incision site clean and dry. 
  • Avoid any strenuous activities such as lifting heavy objects or running for about 6 weeks after the surgery. 
  • Do not have sexual intercourse until the wound has healed completely. 
  • You should drink plenty of water and eat nutritious food like veggies and fruits. Do not forget to include fiber-rich foods in your diet to prevent constipation. 
  • You can return to normal activities within 6 to 8 weeks after the surgery.
  • It can take around 2 months for complete recovery.

What are the Benefits and Risks of an Orchiectomy?

Orchiectomy is a safe and effective procedure with many benefits. If proper care is not taken during recovery, some complications may develop.

Also Read: vasectomy

Benefits

In patients with testicular cancer, orchiectomy is the method of choice, and in prostate and male breast cancer, it is used to lower testosterone levels. In transgenders, orchiectomy reduces the requirement for long-term hormonal therapy to lower the androgen levels. 

Risks

  • Pain and swelling around the wound
  • Bleeding from the site of the surgery
  • Difficulty in urinating
  • Infection at the site of the incision
  • Erectile dysfunction (difficulty in achieving an erection and sustaining it)
  • Reaction to medications given for anesthesia
  • Complications due to the lack of testosterone such as depression (emotional disorder), hot flashes, weight gain, and mood swings.

Why Choose Medfin?

Surgery can be a daunting aspect, and feeling anxious is absolutely normal. The massive amount of information you can get from the internet may confuse you even more. This is where Medfin can help. Leave us the hefty task of finding the best hospital, the finest doctor, and the latest procedure at the lowest cost. Let us take charge while you sit back and focus on your health and recovery. Think surgery! Think Medfin

The power of Medfin in patient’s words

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“ Got to know about them from my friend. They got an appointment for only 299. Once the doctor confirmed that I needed the surgery they got me a fixed cost which included ALL the costs. No extra amounts were charged. Thank you Medfin”

Suresh Menon Hyderabad 8 days ago
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“ After my consultation with the doctor, MEDFIN representative got me a fixed package cost that included my mothers initial tests, surgery cost. They also gave me stockings free for Rs. 3000 post the surgery. They kept up their promise they made”

Radhika Iyer Mumbai 8 days ago
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“ Thank you Medfin. They ensured the whole process from selecting a very experienced doctor to offering the latest procedure at a very reasonable price. They also arranged a follow up post my surgery with the doctor to ensure my recovery was on track. Thank you for being there throughout”

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