What is an orchiectomy?
Orchiectomy is a surgical procedure that removes a testicle and, if needed, the associated structure of the spermatic cord. Depending on the reason, one testicle (unilateral orchiectomy) or both (bilateral orchiectomy) can be removed. It is a routine urological-surgical procedure performed when removal of the testicle is medically justified.
The most common and most important reason for orchiectomy is a suspected testicular tumor. When malignancy is suspected, a so-called radical (inguinal) orchiectomy is done, in which the testicle is removed through an incision in the groin, together with the spermatic cord and blood vessels — which at the same time establishes the diagnosis and carries out the treatment. There is also a subcapsular orchiectomy, in which tissue is removed from the capsule of the testicle, applied in other, non-tumor indications.
Removal of one testicle as a rule does not significantly affect the hormonal balance or fertility, because the remaining, healthy testicle continues to function normally. With a bilateral orchiectomy the situation is different, and the patient is informed in detail about all the consequences in advance, including the options for hormone replacement and, if needed, sperm banking before the procedure.
At Medical Time we approach orchiectomy with full attention to the medical and personal aspects of this procedure. Before the operation a detailed examination and diagnostics are carried out, and the reason, course and expected outcome are clearly explained to the patient, with maximum discretion.
When is an orchiectomy indicated?
The decision on orchiectomy is made carefully, based on an examination, ultrasound and other findings. There are several clear medical situations in which removal of the testicle is necessary or represents the best treatment choice.
The most common indications for orchiectomy are:
- a suspected tumor (cancer) of the testicle — the most common and most important reason for the procedure
- a severe injury of the testicle that cannot be managed in another way
- twisting of the testicle (torsion) with tissue death when the testicle cannot be saved
- a severe, chronic or repeated infection of the testicle that does not respond to treatment
- an infertile, shrunken (atrophic) or undescended testicle that carries a risk
- certain conditions within hormone therapy (for example in advanced prostate cancer)
- chronic testicular pain that does not go away despite other forms of treatment
How an orchiectomy is performed
The way an orchiectomy is performed depends above all on the reason it is being done. For a suspected testicular tumor the standard is a radical, inguinal orchiectomy: the surgeon makes an incision in the groin (not on the scrotum), through which the testicle is removed together with the spermatic cord and blood vessels. This approach is important because it reduces the risk of tumor cells spreading and allows an accurate diagnosis.
For non-tumor indications (for example in hormone therapy or some other conditions), an orchiectomy through an incision on the scrotum can be done, and sometimes a subcapsular orchiectomy, in which tissue is removed from the capsule of the testicle while preserving the outer appearance of the scrotum. Which technique is right is decided by the surgeon based on the diagnosis and the goal of treatment.
The removed tissue is, as a rule, sent for histopathological analysis, which gives the final confirmation of the nature of the change and guides further treatment. When it comes to a tumor, this finding is key for planning any additional therapy and monitoring.
For patients to whom the aesthetic and psychological aspect is important, in certain cases it is possible to discuss the placement of a testicular prosthesis, which restores the appearance of the removed testicle. The patient is informed in detail about all options before the procedure.
Preparation for orchiectomy
Preparation for orchiectomy includes a detailed examination, scrotal ultrasound and, when a tumor is suspected, additional blood tests (tumor markers) and, if needed, imaging to assess the spread. Since the procedure is most often done under general or spinal anesthesia, standard preoperative preparation is also carried out.
Before the operation the anesthesiologist examines the patient and, based on laboratory tests, an ECG and health status, assesses the safest form of anesthesia. Since the procedure is performed under anesthesia, it is important to follow the rules on fasting and to come with accompaniment.
Before the procedure it is important to clarify the following with the doctor:
- all medications you take, especially blood thinners
- chronic illnesses, previous surgeries and any allergies
- plans regarding fertility — with a bilateral orchiectomy sperm banking is considered before the procedure
- the possibility of placing a testicular prosthesis, if that aspect is important to you
- the rules on fasting before anesthesia and arranged accompaniment for the return home
- all earlier findings, ultrasound and tests to bring for review
The procedure, anesthesia and duration
Orchiectomy is most often performed under general or spinal (regional) anesthesia, so the patient feels no pain during the procedure. The choice of anesthesia is decided jointly by the surgeon and the anesthesiologist, depending on the type of procedure and the patient's health status. The entire course of the operation takes place in the sterile conditions of the operating room.
After the anesthesia is introduced, the surgeon makes an incision (in the groin for a radical orchiectomy or on the scrotum for other indications), carefully frees and removes the testicle together with the accompanying structures according to the plan of the procedure, and then stops the bleeding and closes the incision layer by layer. Finally a sterile dressing is placed, and a small drain if needed.
The procedure itself most often takes between 45 minutes and an hour and a half, depending on the type of orchiectomy and on whether a prosthesis is placed. Throughout the operation the anesthesiologist continuously monitors the vital functions — pulse, pressure, breathing and oxygen saturation — so the procedure is safe and controlled.
After the operation the patient wakes and recovers under the supervision of the staff. Depending on the type of procedure and the anesthesia, a return home the same day or a short stay for observation is possible, which the surgeon decides.
Recovery after orchiectomy
Recovery after orchiectomy is, as a rule, tidy and predictable. In the first days mild pain, swelling and bruising in the area of the wound and scrotum are normal and gradually subside. Wearing snug underwear or a supporter helps relieve the area and reduce swelling, so it is often recommended.
Most patients return to lighter activities after a few days, while strenuous physical activities, sport, lifting and sexual activity are postponed according to the surgeon's instructions — usually a few weeks, until the wound has fully healed. The sutures, if they are not absorbable, are removed at the agreed time.
What is recommended during recovery:
- keep the wound clean and dry and dress it according to the instructions
- wear snug underwear or a supporter to relieve the area and reduce swelling
- avoid heavy lifting, strenuous sport and cycling until the wound has healed
- control pain in the first days with analgesics recommended by the doctor
- postpone sexual activity according to the surgeon's advice
- contact the doctor if increased pain, redness, pus, swelling or a temperature appear
Risks and possible complications
Orchiectomy is a safe and standardized procedure, and serious complications are rare. As with any operation under anesthesia, there are general risks (related to anesthesia) and local risks in the procedure area, of which the patient is informed in detail before the operation.
Locally, bleeding and a collection of blood (hematoma) in the scrotum are possible, as well as wound infection, swelling and transient pain, and, rarely, slower healing. With removal of one testicle the hormonal function and fertility as a rule remain preserved thanks to the healthy, remaining testicle. With a bilateral orchiectomy a loss of fertility and a drop in male hormone levels are unavoidable, so hormone replacement and any sperm banking are planned in advance.
The psychological and emotional aspect of removing a testicle is also important and should not be neglected — that is why we approach the patient with understanding, clearly explain all options, including the possibility of a prosthesis, and remain available for all questions. With a proper surgical technique and careful monitoring of recovery, most risks are reduced to the lowest level.
Why have an orchiectomy done at Medical Time
At Medical Time we approach orchiectomy expertly, discreetly and with full attention to each patient. An experienced surgical team, modern hospital conditions and constant anesthesiologist supervision ensure that the procedure is safe and recovery as easy as possible. Everything — from examination and diagnostics, through the operation, to histological analysis and further monitoring — is available in one place.
We attach special importance to clear communication: before the procedure we explain in detail the reason, course and all options, including sperm banking and the possibility of a prosthesis, and after the operation we stay with you for the interpretation of the findings and the further steps of treatment.
- an experienced surgical and urological team and modern hospital conditions
- constant anesthesiologist supervision and high safety standards
- a discreet and careful approach, with clear communication about all options
- complete diagnostics and histological analysis in one place
- a conversation about sperm banking and the possibility of placing a prosthesis
- support and monitoring throughout recovery and further treatment
- quick booking and organized preoperative preparation
Price — orchiectomy
The price of orchiectomy depends on the type of procedure (radical, subcapsular or other), on whether a prosthesis is placed, on the form of anesthesia and the included histological analysis. You get the exact price and an appointment after an examination and assessment, by calling or through the contact form.
- Examination and preoperative assessment
- Radical (inguinal) orchiectomy
- Subcapsular orchiectomy
- Histopathological analysis of the removed tissue
For an individual estimate and an appointment, call 062-399-888.
Frequently asked questions about orchiectomy
During the operation itself you feel no pain, because the procedure is done under general or spinal anesthesia. After the procedure mild pain and swelling in the wound area are possible in the first days, which are controlled with analgesics recommended by the doctor and gradually subside.
With removal of one testicle the remaining, healthy testicle as a rule continues to secrete hormones and produce sperm normally, so fertility and hormonal balance are most often preserved. With a bilateral orchiectomy the situation is different and the patient is informed about it in detail in advance.
The procedure itself most often takes from 45 minutes to an hour and a half. Most patients return to lighter activities after a few days, while strenuous activities and sport are postponed usually a few weeks, until the wound has fully healed.
In certain cases the placement of a testicular prosthesis is possible, which restores the appearance of the removed testicle. You discuss this possibility with the surgeon before the procedure, depending on your situation and wishes.
For a suspected tumor a radical, inguinal orchiectomy is done, in which the testicle is removed through an incision in the groin together with the spermatic cord. Such an approach reduces the risk of tumor cells spreading and allows an accurate diagnosis.
The removed tissue is sent for histopathological analysis, which gives the final confirmation of the nature of the change. That finding is key, especially with a tumor, because it guides further treatment and monitoring.
Yes, especially with a bilateral orchiectomy or when additional therapy that may affect fertility is planned. Sperm banking is considered and agreed before the procedure, and the surgeon will explain all the steps to you.