What is orchiectomy?

Orchiectomy (say "or-kee-EK-tuh-mee") is surgery to remove one or both of your testicles. It is usually done to treat testicular cancer. It may also be done for other reasons, such as removing a damaged testicle or as part of treatment for prostate cancer.

For testicular cancer, the surgery is called a radical inguinal orchiectomy. The doctor makes a cut in the lower belly. The testicle or testicles are removed and the cut is closed with stitches.

For a simple orchiectomy, the doctor removes one or both testicles through a cut in the scrotum.

If desired, artificial testicles (saline implants) can be put into the scrotum.

You should be able to do most of your normal activities after 2 to 3 weeks. But you will not be able to do anything that requires your body to work hard. It's important not to strain with bowel movements or to lift heavy things.

You will probably need to take 2 to 3 weeks off from work. It depends on the type of work you do and how you feel.

With one testicle, you can still get an erection or father a child. But if both testicles are removed, you will not be able to father a child. And you may have problems getting an erection.

It is common to feel sad or depressed after this surgery. You may have concerns about body image and sex. Ask your doctor about support groups or other resources that can help.

Activity

• Rest when you feel tired. Getting enough sleep will help you recover.
• Lie down for 15 minutes several times each day for the first 2 weeks after surgery. This will help reduce the swelling of your scrotum.
• Try to walk each day. Start by walking a little more than you did the day before. Bit by bit, increase the amount you walk. Walking boosts blood flow and helps prevent pneumonia and constipation.
• Avoid strenuous activities, such as bicycle riding, jogging, weight lifting, or aerobic exercise, for 2 to 3 weeks after surgery.
• Avoid lifting anything that would make you strain. This may include a child, heavy grocery bags and milk containers, a heavy briefcase or backpack, cat litter or dog food bags, or a vacuum cleaner.
• Do not drive for 1 to 2 weeks after surgery or until your doctor says it is okay.
• You may take showers. Pat the cut (incision) dry. Do not take a bath for the first 2 weeks, or until your doctor tells you it is okay.
• Your doctor will tell you when you can have sex again.
• Most men are able to return to work or their normal activities in about 2 to 3 weeks after surgery.

Diet

• You can eat your normal diet. If your stomach is upset, try bland, low-fat foods like plain rice, broiled chicken, toast, and yogurt.
• You may notice that your bowel movements are not regular right after your surgery. This is common. Try to avoid constipation and straining with bowel movements. You may want to take a fiber supplement every day. If you have not had a bowel movement after a couple of days, ask your doctor about taking a mild laxative.

Medicines

• Your doctor will tell you if and when you can restart your medicines. You will also be given instructions about taking any new medicines.
• If you stopped taking aspirin or some other blood thinner, your doctor will tell you when to start taking it again.
• Take pain medicines exactly as directed.
  • If the doctor gave you a prescription medicine for pain, take it as prescribed.
  • If you are not taking a prescription pain medicine, ask your doctor if you can take an over-the-counter medicine.
• If your doctor prescribed antibiotics, take them as directed. Do not stop taking them just because you feel better. You need to take the full course of antibiotics.
• If you think your pain medicine is making you sick to your stomach:
  • Take your medicine after meals (unless your doctor has told you not to).
  • Ask your doctor for a different pain medicine.

Incision care

• In most cases, the doctor will use stitches that dissolve on their own in 1 to 3 weeks and do not need to be removed.
• Wash the area daily with warm, soapy water, and pat it dry. Don't use hydrogen peroxide or alcohol, which can slow healing. Cover the area with a gauze bandage until it stops oozing. Change the bandage at least one time a day. Your underwear holds the bandage in place.
• Keep the area clean and dry.

Ice

• Put ice or a cold pack on your scrotum for 10 to 20 minutes at a time. Try to do this every 1 to 2 hours (when you are awake) for the first 2 or 3 days after surgery. Put a thin cloth between the ice and your skin.

Other instructions

• Wear snug underwear or compression shorts to support your scrotum for the first few weeks after surgery.

Surgery can be stressful. This information will help you understand what you can expect. And it will help you safely prepare for surgery.

Preparing for surgery

• Be sure you have someone to take you home. Anesthesia and pain medicine will make it unsafe for you to drive or get home on your own.
• Understand exactly what surgery is planned, along with the risks, benefits, and other options.
• If you take a medicine that prevents blood clots, your doctor may tell you to stop taking it before your surgery. Or your doctor may tell you to keep taking it. (These medicines include aspirin and other blood thinners.) Make sure that you understand exactly what your doctor wants you to do.
• Tell your doctor ALL the medicines, vitamins, supplements, and herbal remedies you take. Some may increase the risk of problems during your surgery. Your doctor will tell you if you should stop taking any of them before the surgery and how soon to do it.
• Make sure your doctor and the hospital have a copy of your advance directive. If you don’t have one, you may want to prepare one. It lets others know your health care wishes. It’s a good thing to have before any type of surgery or procedure.

Orchiectomy surgery is relatively low-risk. Complications aren't common. But orchiectomy carries all the risks of any major surgery, including:

• Reactions to anesthesia or medicines.
• Infection.
• Bleeding.

Bilateral orchiectomy (removal of both testes) is rarely done and carries the possibility of side effects. They are related to the loss of testosterone after the removal of both testes. These include:

• Infertility.
• Loss of sexual interest.
• Erection problems.
• Hot flashes.
• Breast enlargement (gynecomastia).
• Weight gain.
• Loss of muscle mass.
• Osteoporosis.

Orchiectomy can be done as an outpatient procedure or with a short hospital stay. Most people get back to their regular activities in 1 to 2 weeks. And you can expect a full recovery in 2 to 4 weeks.

Orchiectomy (say "or-kee-EK-tuh-mee") is surgery to remove one or both testicles. This is mainly done to treat testicular cancer or advanced prostate cancer.

You can expect to feel better each day. But you may have some mild to moderate pain for several days after surgery. You may need pain medicine during this time. Your scrotum will be swollen after surgery. This is normal. The swelling usually goes down within 2 to 4 weeks.

You should be able to do most of your normal activities after 2 to 3 weeks, except for those that require a lot of physical effort. It's important to avoid straining with bowel movements and doing heavy lifting while you recover.

If both your testicles were removed, you may start to notice changes in your body several weeks after surgery due to not having male hormones. The most obvious changes may be hot flashes and sweating. You may lose your sex drive, gain weight, or not be able to get an erection. These changes can be upsetting. Talk to your doctor about treatments that might help with these.

• Follow the instructions exactly about when to stop eating and drinking. If you don't, your surgery may be canceled. If your doctor told you to take your medicines on the day of surgery, take them with only a sip of water.
• Take a bath or shower before you come in for your surgery. Do not apply lotions, perfumes, deodorants, or nail polish.
• Do not shave the surgical site yourself.
• Take off all jewelry and piercings. And take out contact lenses, if you wear them.

At the hospital or surgery center

• Bring a picture ID.
• The area for surgery is often marked to make sure there are no errors.
• You will be kept comfortable and safe by your anesthesia provider. You will be asleep during the surgery.
• The surgery will take about 1 hour.