Surgical Procedures: Orchiectomy

An orchiectomy is the surgical removal of one or both testicles. The testicles rest below the penis in the scrotum. The testicles are glands that make sperm and testosterone (a hormone).

Orchiectomy may be used as a treatment for: 

• Testicular and/or prostate cancer. 
• Male breast cancer. 
• Cancer prevention in men with an undescended testicle after puberty. 
• Severe trauma or injury to the testicle.   
• Male-to-female gender reassignment surgery.

There are different types of orchiectomy, including:

• Radical Inguinal Orchiectomy: The testicle and spermatic cord are removed through an incision (cut) made in the groin. At times, a prosthetic (artificial) saline-filled testicular implant can be placed.
• Simple Orchiectomy: During a simple orchiectomy, the testicle is removed through the scrotum. As in a radical inguinal orchiectomy, a prosthetic testicle can be inserted. In both simple and radical orchiectomy, a single testicle can be removed, or both testicles, which is called bilateral orchiectomy.
• Subcapsular Orchiectomy: During a subcapsular orchiectomy, only the glandular tissue lining the testicles is removed, leaving the testicles in place.

What are the risks associated with an orchiectomy?

As with any surgery, there are risks and possible side effects. These can be:

• Reaction to anesthesia (anesthesia is the medication you are given to help you sleep through the surgery, not remember it, and to manage pain. Reactions can include wheezing, rash, swelling, and low blood pressure). 
• Bleeding.
• Infection.
• Blood clots.
• Loss of fertility(ability to father a child). 
• Erectile dysfunction.
• Loss of feeling in the groin and/or genitals.
• Low libido (sex drive).
• Hot flashes, mood swings, depression.
• Loss of muscle mass.
• Osteoporosis.
• Breast enlargement (gynecomastia).
• Weight gain.
• Fatigue.
• Change in self-image.

What is recovery like?

Recovery from an orchiectomy may include a short stay in the hospital, depending on the type of procedure you have had. You will be taught how to care for your incision before being discharged from the hospital.

Your medical team will discuss with you the medications you will be taking, including those to prevent blood clots, infection, and constipation, and those for pain control and nausea.

Your provider will tell you what you should and should not do when you go home. This will often include:

• Wear a scrotal support and use ice packs as directed.
• Take pain medication as prescribed.
• Avoid straining with bowel movements and try to prevent constipation.
• Use a donut cushion when sitting for comfort. 
• Do not lift anything heavy until told it is safe to do so by your provider.
• No sports, jogging or running until you are told it is safe to do so. 

Driving, resuming sexual activity, and returning to work should be discussed with your healthcare team.

What will I need at home?

• Thermometer to check for fever, which can be a sign of infection.
• Ice packs.
• Scrotal support, such as a jockstrap.

When do I call my healthcare team?

Call your healthcare team if you have any of the following:

• Fever or chills. Your team will tell you at what temperature they should be contacted. 
• Groin redness and/or swelling.
• Swelling in the scrotum.
• Drainage and/or bleeding at the incision. 
• Not being able to urinate.

How can I care for myself?

You may need a family member or friend to help you with your daily tasks until you are feeling better. It may take some time before your team tells you that it is ok to go back to your normal activity.

Be sure to take your prescribed medications as directed to prevent pain, infection and/or constipation. Call your team with any new or worsening symptoms.

There are ways to manage constipation after your surgery. You can change your diet, drink more fluids, and take over-the-counter medications. Talk with your care team before taking any medications for constipation. 

Taking deep breaths and resting can help manage pain, keep your lungs healthy after anesthesia, and promote good drainage of lymphatic fluid. Try to do deep breathing and relaxation exercises a few times a day in the first week, or when you notice you are extra tense.

• Example of a relaxation exercise: While sitting, close your eyes and take 5-10 slow deep breaths. Relax your muscles. Slowly roll your head and shoulders.

This article contains general information. Please be sure to talk to your care team about your specific plan and recovery.