Treatment / Operations to Remove Testis

Simple Orchidectomy, Radical Orchidectomy
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Operations to Remove the Testicle: Indications and Implications

Introduction

The surgical removal of one or both testicles is known as orchiectomy or orchidectomy. The procedure is carried out for various medical reasons, both benign and malignant. This article aims to elucidate the reasons for testicular removal, the process itself, and the post-operative considerations.

Why Remove a Testicle?

  1. Malignancy: Testicular cancer is the most common reason for removing a testicle. Early detection and removal can prevent the spread of cancer.
  2. Benign Conditions:
    • Testicular Torsion: Twisting of the testicle, leading to restricted blood flow and potential damage.
    • Chronic Infection or Abscess: Persistent infections that don’t resolve with antibiotic treatment.
    • Severe Trauma: Injury that results in irrevocable damage to the testicle.
    • Atrophy: Shrinking of the testicle due to conditions like mumps orchitis.

Types of Orchiectomy

  1. Simple Orchiectomy: Removal of one or both testicles through an incision in the scrotum. This is generally performed for benign conditions.
  2. Radical Inguinal Orchiectomy: The testicle is removed through an incision in the groin. This is the standard procedure for testicular cancer to ensure cancerous cells do not spread.

The Surgical Process

  • Preparation: A complete physical examination, blood tests, and imaging studies are performed. Discussions regarding sperm banking might be necessary for patients planning to have children in the future.
  • Procedure: General or local anesthesia is used. Depending on the type of orchiectomy, an incision is made in the scrotum or the groin to remove the testicle(s).
  • Recovery: Most patients can go home the same day. Pain, swelling, and bruising are common but temporary.

Post-operative Care and Considerations

  1. Physical Recovery: Returning to regular activities typically takes a few weeks. Pain can be managed with prescribed painkillers.
  2. Emotional Aspects: Some men might experience feelings of loss or lowered self-esteem. Counseling or support groups can be beneficial.
  3. Prosthetic Testicle: An artificial testicle can be implanted for cosmetic reasons, offering a natural look and feel.
  4. Fertility: One healthy testicle can maintain normal testosterone levels and fertility. However, if both testicles are removed, testosterone replacement therapy will be necessary, and natural conception will be impossible.

Conclusion

The decision to undergo an orchiectomy is significant and often laden with emotions. Thorough understanding and discussions with healthcare professionals can help in navigating this journey. Whether it’s for benign conditions or malignancy, the primary goal is always the health and well-being of the patient. Exploring available resources, engaging with support communities, and prioritising physical and emotional recovery is essential.

 

External Links for Further Reference:

  1. NHS – Testicular Cancer Treatment
  2. Cancer Research UK – Surgery for Testicular Cancer
  3. British Association of Urological Surgeons leaflet for Removal of Testic for Cancer
  4. British Association of Urological Surgeons leaflet for Removal of Testic for Benign Conditions