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Unilateral Orchidectomy
What is
Unilateral Orchidectomy?
The
surgical removal of one of the testicles is
called a unilateral orchidectomy.
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Effects
of Unilateral Orchidectomy
Undergoing a unilateral orchidectomy is done for
cancer treatment and also for lowering the level
of the primary male sex hormone in the body, the
testosterone.
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Candidates for Unilateral Orchidectomy
Ideal
candidates for a unilateral orchidectomy are
those who have cancer of the testicle(s), those
who have suffered any injury or trauma to the
testicle(s), or those whose advanced prostate
cancer may have spread to the testes. Candidates
for this procedure may also be those who have
cryptorchidism or undescended testes since this
increases a patient's risk of testicular cancer.
On the other hand, this increased risk does not
change even after the surgery is done and the
testicles have already descended in the scrotum.
A prophylactic orchidectomy may also be done in
patients who are high risk, that is, a family
history of testicular cancer. Orchitis, the
inflammation of the testes which presents as a
swelling and a lump in the scrotum, should be
excluded first by the doctor before carrying out
an orchidectomy.
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Your Consultation
Standard blood and urine tests
will be done by patients preparing for an
orchidectomy prior to undergoing the procedure.
Aspirin-based medications should be discontinued
one week postoperatively. Nonsteroidal
anti-inflammatory drugs (NSAIDs) should be
discontinued two days before the procedure.
Eating and drinking anything eight hours prior
to the scheduled surgery is not allowed.
The patients are requested by their surgeons to
shower or bathe on the morning of the procedure
with the use of an antibacterial soap. They
should thoroughly lather, scrub, and rinse their
genitals and inguinal area.
A sedative may be administered before the
surgery to patients who are anxious or nervous
in order to relax them.
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The
Unilateral Orchidectomy Procedure
The unilateral orchidectomy is done under
general anesthesia. It may or may not be
necessary to undergo hospitalization prior to
the procedure. Before the orchidectomy, the area
of the lower abdomen and scrotum will be shaved
and then cleansed thoroughly. In order to make
certain that no pain during the orchidectomy
procedure will be experienced, either a general
anesthesia or a local anesthesia with spinal
block will be administered. Through an incision
maid in the scrotum or the groin or inguinal
area, the testicle will then be removed. After
the operation, suturing of the incision will be
made. The whole procedure usually takes about 30
minutes to one hour. Insertion of a prosthesis
or a scrotal implant or an artificial
replacement for the testes in the scrotum may be
recommended by the surgeon in order to give the
scrotum a normal appearance. Removal of some
lymph nodes situated deep in the abdominal or
inguinal area may also be done.
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Recovery
Arrangements should be made for the patient who
will have an orchidectomy done in an ambulatory
surgery center or an outpatient facility for a
friend or a family member to drive him home
after undergoing orchidectomy. A day after the
procedure, majority of the patients may be able
to go back to work although some may still
require an additional day of rest at home.
Nausea may be felt by the patient after the
anesthetic wears off. Even though this may be
normal, the patient must be able to start eating
regularly after being discharged home. Pain and
swelling may also be expected after the
procedure. This can be relieved by taking
painkillers prescribed by the doctor for a few
days.
The following are recommendations for hastening
the patient's recovery:
. Avoid sexual activity, strenuous exercise,
heavy lifting until the patient comes back for
his follow-up visit with the doctor.
. Extra fluids should be taken for the next
several days. Caffeinated and alcoholic
beverages should be avoided.
. Ice pack should be applied to the groin area
for the first 24-48 hours post surgery.
. Showering instead of a tub bath one week after
surgery should be done in order to lessen the
risk of premature dissolving of the absorbable
stitches.
. Wear a jock strap or snug briefs two weeks
postoperatively in order to support the scrotum.
Psychological counseling after an orchidectomy
may be required to patients as part of their
long-term aftercare.
Part of the long-term aftercare of patients with
testicular cancer includes regular check-ups
together with radiation or chemotherapy.
Hormonal therapies or radiation treatment may be
given to patients with prostate cancer.
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Risks
Just
like any other procedure, there are risks
involved in an orchidectomy done under general
anesthesia. Some of them are the risk of
developing deep venous thrombosis, heart
problems, respiratory problems, bleeding,
infection, or an adverse reaction to
anesthesia. Bleeding into the spinal canal,
damage to the nerve, or a spinal headache are
the risks involved in an epidural anesthesia.
The
following are the specific risks involved with
an orchidectomy:
-
Breast enlargement and tenderness
-
Fatigue
-
Hot
flashes like those in menopausal women which
may be controlled with medications
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Impotence
-
Loss
of sexual desire which can be treated with
hormone injections or gel preparations
-
Loss
of sensation in the genitals or the inguinal
area
-
Mood
swings or depression
-
Osteoporosis
-
Weight gain of approximately 10-15 pounds or
4.5-6.8 kilograms
Another risk involved specific to cancer
patients is the recurrence of cancer
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Frequently Asked Questions
Q:
What is the outcome of an orchidectomy?
A:
The treatment of choice of early testicular
cancer is an orchidectomy. After the surgical
removal of the testicles or an orchidectomy,
prostate cancer is known to regress as the
source of the testosterone is removed. Studies
show a 95-97% five‑year disease-free survival
rate in men with early testicular cancer.
Although orchidectomy is not considered a cure
for prostate cancer, this procedure actually
increases a patient's rate of survival. There
may be a chance that cancer may be completely
eradicated without the need for adjuvant
treatment such as radiotherapy or chemotherapy
when an orchidectomy is performed. On the other
hand, one has to still be cautious and watch for
signs and symptoms of recurring cancer.
Q:
How does one benefit from an orchidectomy?
A:
An orchidectomy is an efficient procedure for
the removal of testicular tumor. Chemotherapy
or radiation therapy may or may not be needed
after the operation. It is also believed that
bone pain may be relieved and causes prostate
cancer to shrink.
Q:
What are the alternatives to an orchidectomy?
A:
Testicular cancer or advanced prostate cancer
are the indications for an orchidectomy.
Choosing not to have an orchidectomy for these
indications is actually putting the patient at a
higher health risk.
The
following are alternatives to orchidectomy:
-
Adjunct therapies such as
chemotherapy, radiation therapy, hormonal
therapy, or a combination of all these
treatments.
-
Estrogen and progesterone
(female hormones) use in order to counteract
the effects of too much testosterone
production
-
Use of medications that are
able to block the production or effects of
testosterone (male hormones)
The following list of Urology procedures are
performed at Beverly Hills Medical Group -
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