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Orchidectomy for Benign Problems

What does the procedure involve?

Orchidectomy is the surgical removal of one or both testicles. The reason is for the treatment of benign disease. Removal of the testis is performed via a groin or scrotal incision. A testicular prosthesis can be inserted at the same time, at your request.

What are the alternatives to this procedure?

The only alternative to this procedure is observation without any treatment.

What should I expect before the procedure?

You will usually be admitted to hospital on the same day as your surgery. You will be asked not to eat and drink for six hours before surgery. Immediately

before the operation, the anaesthetist may give you a pre-medication, which will make you dry-mouthed and pleasantly sleepy.

Please tell your surgeon (before your surgery) if you have any of the following:

  • An artificial heart valve.
  • A coronary artery stent.
  • A heart pacemaker or defibrillator.
  • An artificial joint.
  • An artificial blood-vessel graft.
  • A neurosurgical shunt.
  • Any other implanted foreign body.
  • A regular prescription for a blood thinner e.g. Warfarin, Coumadin Xarelto®, Pradaxa®, Clopidogrel (Plavix®), Brilinta®, or Aspirin.
  • Previous or current infection with an antibiotic resistant organism such as MRSA, VRE, etc.

What happens during the procedure?

Either a full general anaesthetic (where you will be asleep) or a spinal anaesthetic (where you are unable to feel anything from the waist down) will be used. All methods reduce the level of pain afterwards. Your anaesthetist will explain the pros and cons of each type of anaesthetic to you.

The surgeon will remove your testicle through a small incision either in the groin or in the scrotum, depending on where the testicle lies. If you have requested an artificial testicle, it is put into the scrotum and we close off the top of the scrotum with stitches to prevent it moving up into the groin. We also fix the prosthesis to the inside of the scrotum to prevent it from “tumbling”.

What happens immediately after the procedure?

You may have some discomfort for a few days after the procedure but we will give you painkillers to take home. Absorbable stitches are normally used which do not require removal.

The average hospital stay is 1-2 days.

Are there any side-effects?

Most procedures are straightforward but as with any operation there are potential complications.

Common (greater than 1 in 10)

  • Swelling of the scrotum, which may last several days.
  • Seepage of yellowish fluid from the wound after several days.

Occasional (between 1 in 10 and 1 in 50)

  • Infection of incision needing further treatment including removal of the implant.
  • Bleeding from the wound and possible removal of the implant.
  • No guarantee that you will be fertile in the future.

Rare (less than 1 in 50)

  • Unsuspected findings on pathology, needing further treatment.
  • Pain, infection or leaking needing removal of the implant.
  • Cosmetic result is not always perfect.
  • The implant may ride up in warm weather and lie at a higher level than the other testicle.
  • You can feel a stitch at one end of the implant.
  • The long-term risks from use of silicone products are unknown.

What should I expect when I get home?

The groin and scrotum may be uncomfortable for 7 to 10 days but we normally give you simple painkillers to take home.

You are advised to take 10 to 14 days off work and to refrain from vigorous exercise (including sport) for six weeks.

What else should I look out for?

If you develop a temperature, increased redness, throbbing or drainage at the site of the operation, please contact your Surgeon or GP. In case of an emergency attend your nearest emergency department or call ‘000’.

Are there any other important points?

Please make sure you have a follow up appointment with your surgeon.

Disclaimer

This information is intended as a general educational guide and may not apply to your situation. You must not rely on this information as an alternative to consultation with your urologist or other health professional.

Not all potential complications are listed, and you must talk to your urologist about the complications specific to your situation.