Surgery (Orchidectomy)

An orchidectomy is surgery to remove a testicle.

It is usually a simple procedure that takes about half an hour under general anaesthetic. Often patients go home the same day.

During surgery a small incision is made into the groin on the affected side and the testicle is removed from above. The scrotum is not cut.

A prosthetic (artificial) testicle can be inserted to replace the testicle that has been removed. Once the artificial testicle is inserted, the neck of the scrotum is closed with stitches to stop the false testicle moving.

About 5% of men with testicular cancer may also have pre-cancerous or cancerous cells in the other testicle. If this is suspected, a biopsy of the other testicle may be taken during your operation.

Men may also be offered sperm storage before surgery. You can read more about this on our Fertility page.

Your healthcare team will ask if you would like a false (prosthetic) testicle to replace the old one.

These are silicone implants that can be inflated with salt water. They come in various sizes and give a very good cosmetic result.

Having a false ‘ball’ can make you feel much better. However, some men may experience problems with them in the longer term.  Problems can include:

• The overall cosmetic result.
• The prosthetic testicle will not react to temperature like a normal one, remaining the same size.
• Scar tissue can form around the implant inside the scrotum. This can sometimes cause thick, fibrous tissue to grow, which may cause discomfort or create concern about cancer coming back.
• Rupture of the implant can occur after vigorous activities like contact sport, cycling or sexual intercourse.
• Sometimes the implant can move out of its original position.

There is no right or wrong decision. If men are not sure whether to have an implant, the procedure can be performed at a later date.

The video below explains more about orchidectomy.

There will be a dressing covering the incision on the groin which can usually be removed 24 hours after the operation. The stitches (sutures) in the wound will usually be dissolvable but may take some weeks to fully disappear.

More blood tests for tumour markers may be performed a few days after orchidectomy. Sometime markers that were abnormal before surgery may have returned to normal. This can help in deciding further treatment.

• After 24 hours, men should be able to have a bath or shower but should avoid rubbing soap on the wound area. The wound should be dried by gently patting it with a clean towel or gauze pad.
• The groin and scrotal area can feel bruised and swollen after the operation. Men should wear close fitting underwear such as briefs or ‘Y’ fronts or a scrotal support rather than boxer shorts. This will help the bruising settle.
• For the first 48 hours, it is a good idea to take painkillers on a regular basis, not just when pain is felt. Often simple paracetamol combined with an anti-inflammatory medication (such as ibuprofen) is effective at reducing discomfort.
• Although this is a minor operation, it is important to take things easy for the first week. Men should be able to return to work within a few weeks. However, it might be better to wait until the results of the surgery have been discussed  as a referral to an oncologist (cancer specialist) will usually be made in case further treatment such as chemotherapy is needed. If this is the case men may need further time off work.
• Occasionally a collection of blood may form under the surgical wound (called a haematoma). The wound could also become infected. In either of these situations men should seek medical advice. It is sometimes useful to phone the unit that performed your operation, the number of a specialist nurse or GP.
• For the first few weeks, it is important to avoid heavy lifting or strenuous exercise.
• Men should only start driving if they are able to perform an emergency stop without hesitation.

Provided it is not uncomfortable, sexual activity can begin again two weeks after your surgery.  Having an orchidectomy should not affect a mans ability to have an erection but the stress of a cancer diagnosis may affect performance.

Men will usually be given a follow up appointment within a few weeks of their operation to see a hospital specialist called an oncologist who will discuss the results of surgery and any further treatment that has been reccomended.