An Orchiectomy

Medicine and Health

If you've been diagnosed with testicular cancer or are considering feminizing surgery (also called gender-affirming surgery), your doctor has probably talked to you about an orchiectomy, a surgery to remove one or both testicles. Testicles, or testes, are the male sex organs that make sperm and the hormone testosterone. 

If you have testicular or prostate cancer, your doctor may recommend an orchiectomy. (Photo credit: The Image Bank/Getty Images)

Why Get an Orchiectomy?

There are several reasons why you may need or want an orchiectomy. It's usually needed to diagnose testicular cancer or treat testicular, prostate, or male breast cancers. It can also help if your testicle is damaged by infection or injury. 

When both of your testicles are removed, your body cannot make sperm and you will be unable to have children. You will also produce much less testosterone, which can lower your sex drive and your ability to get an erection.

Types of an Orchiectomy:-

It depends on what type of orchiectomy you are getting. There are three types of orchiectomy:

• Simple orchiectomy: This type is usually used to treat advanced prostate cancer and male breast cancer. A simple orchiectomy can involve the removal of just one or both testicles. A bilateral orchiectomy (removal of both testicles) is also the type used for male-to-female transition surgery because it allows for additional feminizing surgery, if desired. During a simple orchiectomy, the testicles are removed through a cut in the scrotum.
• Subcapsular orchiectomy: This type is also used to treat prostate cancer. It’s similar to a simple orchiectomy, but only the tissue that surrounds the testicles is removed. This helps keep the appearance of a scrotum.
• Radical inguinal orchiectomy: Rather than doing a biopsy of the testes, which can trigger cancer spread, doctors almost always do what’s called a radical inguinal orchiectomy for testicular cancer. It's called "radical" because it removes the spermatic cord along with the testicle and tumor. The cord has blood and lymph vessels that could let the cancer spread to other parts of the body. A radical inguinal orchiectomy involves removing the testicles and spermatic cord through a cut in the groin area.

A simple orchiectomy takes about 30 minutes, while a radical inguinal orchiectomy can take about an hour. After surgery, you will be taken to a recovery area and monitored as you wake from anesthesia. You will probably be able to go home the same day, provided someone drives you home. But, in some cases, you may have to stay in the hospital for a night or two. 

Orchiectomy Advantages

Orchiectomy can offer several benefits, such as:

• Effectively diagnose and remove testicular tumors
• May eliminate the need for chemotherapy or radiation therapy
• May cause prostate shrinkage
• Can lower testosterone levels to treat prostate and male breast cancers, or reduce or eliminate the need for hormone therapy if you are a transgender or nonbinary patient. Although the risk is rare, long-term estrogen therapy can cause health problems such as blood clots. 

Orchiectomy Side Effects

As with any surgery, an orchiectomy comes with risks, such as bleeding, infection, blood clots, and reaction to anesthesia. Some orchiectomy side effects are caused by the drop in testosterone. These may include:

• Low sex drive
• Sexual or erectile dysfunction
• Depression
• Loss of muscle mass
• Osteoporosis
• Hot flashes
• Weight gain
• Mood swings
• Loss of feeling in the groin