Testicle Removal

What is testicle removal?

Testicle removal is surgery to remove a man's testicles. The testicles are part of the male reproductive system. They make sperm and the male hormone testosterone. They are in the scrotum, which is the sac of loose skin below the penis.

The medical term for removal of the testicles is orchiectomy.

When is it used?

One or both testicles may be removed to treat cancer in the testicles. They may be removed also if you have cancer in your prostate gland and the cancer has spread to other parts of your body. Prostate cancer cells need testosterone to grow. Removing both testicles can lower the amount of this hormone in your body. When there is less testosterone in the body, prostate cancer may grow more slowly, stop growing, or, more likely, shrink for months to a few years. If the cancer has spread to your bones, you should have less pain in these areas after the surgery.

Rare reasons for removing the testicles include severe infection or a birth defect called torsion that cuts off blood flow to the testicles.

Instead of this procedure, other treatments for prostate cancer may include:

• radiation therapy or surgical removal of the prostate gland if the cancer has not spread past the gland
• female hormone therapy, such as estrogen
• medicine that keeps the testicles from making male hormone
• medicine that blocks effects of male hormones
• medicine to kill cancer cells (chemotherapy)
• radiation therapy to painful bones if the cancer is causing pain

You may choose not to have treatment. Ask your healthcare provider about your choices for treatment and the risks.

How do I prepare for this procedure?

• If both testicles are removed, you will be sterile and unable to have children after the procedure. Your provider may recommend that you put some sperm in a sperm bank before the procedure. The sperm might then be used later on if you want to have children.
• Make plans for your care and recovery after you have the procedure. Find someone to give you a ride home after the procedure. Allow for time to rest and try to find other people to help with your day-to-day tasks while you recover.
• Follow your provider's instructions about not smoking before and after the procedure. Smokers may have more breathing problems during the procedure and heal more slowly. It is best to quit 6 to 8 weeks before surgery.
• Tell your provider if you have any food or medicine allergies.
• Some medicines (like aspirin) may increase your risk of bleeding during or after the procedure. Ask your healthcare provider if you need to avoid taking any medicine or supplements before the procedure.
• You may or may not need to take your regular medicines the day of the procedure, depending on what they are and when you need to take them. Tell your healthcare provider about all medicines and supplements that you take.
• Your healthcare provider will tell you when to stop eating and drinking before the procedure. This helps to keep you from vomiting during the procedure.
• Follow any instructions your healthcare provider may give you.
• Ask any questions you have before the procedure. You should understand what your healthcare provider is going to do. You have the right to make decisions about your healthcare and to give permission for tests or procedures.

What happens during the procedure?

The surgery is usually done at a surgery center.

In most cases you will be given local or regional anesthesia. The anesthesia will keep you from feeling pain during the procedure. Local or regional anesthesia numbs part of your body while you stay awake.

Your healthcare provider will make cuts in your groin and remove the testicles. Your provider will then close the cut.

You can ask your provider to insert a saline-filled replacement (prosthesis) for the testicles in your scrotum to give the look and feel of a normal scrotum.

The procedure usually takes about 1 hour.

What happens after the procedure?

After the surgery you may stay in a recovery area for at least a few hours and then you can usually go home.

Follow your healthcare provider's instructions to keep the wound clean and dry. Wash your hands before and after touching the wound. Wear loose fitting clothing to keep from irritating the incision.

Ask your healthcare provider:

• how long it will take to recover
• what activities you should avoid, including lifting, and when you can return to your normal activities
• how to take care of yourself at home
• what symptoms or problems you should watch for and what to do if you have them

Make sure you know when you should come back for a checkup.

After your testicles are removed, you may have:

• weight gain
• a loss of sex drive
• trouble having erections

Because of the far-ranging effects of this operation, you will want to talk to your healthcare provider about your concerns.

What are the risks of this procedure?

Your healthcare provider will explain the procedure and any risks. Some possible risks include:

• In rare cases you may have an allergic reaction to medicines used during the procedure.
• The cancer may not get better, and you may need other treatment.
• You may have infection or bleeding.

Every procedure or treatment has risks. Ask your healthcare provider how these risks apply to you. Be sure to discuss any other questions or concerns that you may have.