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Radical Orchidectomy
What is
Radical Orchidectomy?
The
process of excising the testis or both testes
through surgery is called an orchidectomy.
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Effects
of Radical Orchidectomy
Cancer
may be treated through this procedure as well as
the lowering of the level of testosterone in the
body, which is the primary male sex hormone.
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Candidates for Radical Orchidectomy
A man
has two testicles (testis) that sit in the
scrotal sac by the penis. Candidates for this
procedure are those who need to have one of the
testicles removed as a testicular cancer may be
suspected.
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Your Consultation
Standard blood and urine tests
are done prior to the procedure for patients
preparing for an orchidectomy. A week before
undergoing the procedure, aspirin-based
medications should be discontinue while all
nonsteroidal anti-inflammatory drugs (NSAIDs)
are stopped two days before surgery. No eating
or drinking eight hours before the scheduled
time of surgery.
Using an antibacterial soap, patients are
requested to bathe on the morning of the
surgery. Extra time should be allotted to
lather, scrub, and rinse their genitals and
groin area.
A sedative is usually given before the procedure
to patients who are anxious or nervous in order
to help them relax.
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The
Radical Orchidectomy Procedure
The procedure is also known as inguinal
orchidectomy as the incision is made in the
groin region rather than directly into the
scrotum. The incision made by the surgeon is
approximately 3 in or 7.6 cm long. The entire
spermatic cord as well as the testicle itself
are removed by the surgeon and is called a
radical orchidectomy. Complete removal is
performed as testicular cancer often spreads
from the spermatic cord into the lymph nodes
near the kidneys. In case a later surgery is
warranted, a long non-absorbable suture is
maintained in the stump of the spermatic cord.
A saline solution is used by the surgeon to wash
the area after the cord and testicle have been
removed. Various layers of tissues and skin with
various types of sutures are also closed by the
surgeon. After this, a sterile gauze is then
used to cover the wound and then bandaged.
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Recovery
The patient may stay overnight in the hospital.
Since the patient has been under anesthesia, one
is not allowed to drive a car, drink alcohol, or
operate machinery 24 hours after the procedure.
It is important that arrangements have been made
for someone to drive the patient home from the
hospital.
Pain or discomfort at the wound site may be felt
a few days after being discharged home following
the operation. This can be relieved with
prescribed or recommended painkillers. To
provide some comfort to the patient, supportive
underpants or loose trousers may be worn. A
minimal amount of swelling may be observed after
the procedure or sometimes even a slight
bruising of the scrotum may be found. Resting
for a few days with the legs elevated would
promote healing and reduction of any potential
swelling in the scrotal area. If antibiotics is
prescribed, make sure that you take the whole
course given as instructed.
Bathing or showering is allowed about 24 hours
after the surgery in order to let the water soak
off the wound dressing; however, bubble baths
and scented soaps should be avoided. Make sure
that one has dried himself carefully afterwards.
Before discharge, make sure that you check
whether you may require removal of the stitches
after 10 days. On the other hand, the stitches
may dissolve after approximately two to three
weeks.
Once the patient feels comfortable and is
confident that he or she can manage the
activities that his or her job entails, the
patient may then be able to return to work. Sex
is avoided until the wound is healed and there
is no more pain felt.
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Risks
Just
like other procedures done under general
anesthesia, there are risks to expect in an
orchidectomy. The following risks include deep
venous thrombosis or DVT, heart problems,
breathing problems, bleeding, infection, or
reaction to the anesthesia. Bleeding into the
spinal canal, nerve damage, or a spinal headache
are expected in patients who had undergone an
epidural anesthesia.
The
following are the specific risks that are linked
with an orchidectomy:
-
Hot
flashes like those in women with menopause
which may be controlled by medication.
-
Impotence
-
Loss
of sensation in the groin area or the genitals
-
Loss
of sexual desire which may be treated by
hormone injections or gel preparations.
-
Mood
swings or depression
-
Increased risk of osteoporosis especially for
men who are taking hormone treatments for
prostate cancer
-
Tenderness and enlargement of the breasts
-
Weight gain of approximately 10-15 pounds or
4.5 to 6.8 kilograms
-
Fatigue
Also
an included risk in orchidectomy is the
recurrence of cancer.
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Frequently Asked Questions
Q: What is an orchidectomy for?
A:
An orchidectomy is mainly for cancer treatment.
It is also for lowering the level of the primary
male sex hormone, the testosterone, in the
body. When a tumor is found within the gland
itself, the usual treatment done is the surgical
removal of the testicle. Prostate cancer or
cancer of the male breast may be treated by
performing an orchidectomy as testosterone
causes these kinds of cancer to grow and spread
to other parts of the body or metastasize. When
an undescended testicle is found in a patient
who is beyond the age of puberty, cancer may be
prevented by doing an orchidectomy.
Q: What are the different types or orchidectomy?
A:
The orchidectomy procedure has three basic
types, namely simple, subcapsular, and inguinal
also known as radical. The simple and
subcapsular orchidectomy are usually done under
local or epidural anesthesia and takes only
about a half an hour to complete. General
anesthesia is utilized when undergoing an
inguinal orchidectomy. This procedure usually
takes about 30 minutes to one hour to perform.
Q: What is an inguinal orchidectomy?
A:
An inguinal orchidectomy is also known as a
radical orchidectomy. This is performed when we
are suspecting the presence of a testicular
cancer. This may be done either unilateral
which means it involves only one testicle or
bilateral meaning both. The surgeon creates an
incision which is approximately 3 in or 7.6 cm
long in the patient's groin or inguinal area
instead of directly into the scrotum, hence its
name. It is also called a radical orchidectomy
because it involves the removal of the entire
spermatic cord, as well as the testicle itself.
Q: What are the complications in this
procedure?
A:
One of the complications experienced with a
radical orchidectomy is bleeding resulting in
scrotal hematoma or retroperitoneal hematoma.
Infection of the wound may also occur. Another
is the possibility of an ilioinguinal nerve
injury resulting in hypoesthesia of the
ipsilateral (same side) groin and lateral
hemiscrotum.
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performed at Beverly Hills Medical Group -
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