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Orchiectomy

Synonyms: Orchidectomy, Castration, Surgical Removal of Testicles

What is Orchiectomy?

Orchiectomy, also known as Orchidectomy or Castration is a surgical procedure to remove one or both testicles in men. Testicles are sex organs in the males that produce sperms and testosterone (a hormone). Orchiectomy will make you sterile (infertile) and may reduce your sex drive due to loss of testosterone.

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Where can I get Orchiectomy?

Country Cost with MedSolution
India (Please inquire for price)
Cost of procedure performed in the US: $4,000 to $7,000.
All prices are in US dollars and include the cost of the procedure and minimum hospital stay. Estimates and minimum hospital stay will vary depending upon individual needs and requirements.

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What are the types of Orchiectomy?

Orchiectomy can be:

  • Unilateral Orchiectomy - Only one testicle is removed, either the right or the left.
  • Bilateral Orchiectomy or Radical Orchiectomy - Both the testicles are removed
  • Inguinal Orchiectomy - The operation is performed through an incision in the groin
  • Scrotal Orchiectomy - The operation is performed by making an incision through the scrotum.

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Who is an ideal candidate for Orchiectomy?

If you have cancer of the testicle(s), if you have suffered any injury or trauma to the testicle(s) or if you have advanced prostate cancer that might have spread to the testes, then you are an ideal candidate for Orchiectomy. Cryptorchidism or Undescended Testes has a higher risk of testicular cancer. This increased risk does not change even after the surgery is performed to move the testicles down in the scrotum. In some high risk candidates (those with a family history of testicular cancer), a prophylactic Orchiectomy might be indicated. It is important for your physician to exclude orchitis (inflammation of the testes which can also present as swelling and lump in the scrotum) before performing Orchiectomy.

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How do I prepare for Orchiectomy?

You physician will request some special blood tests that will include serum tumor markers like AFP (alpha feto-protein) , beta-hCG, and LDH. Routine blood and urine analysis, CT of abdomen and chest x-ray will be requested by your physician on your pre-oparative consult. Inform your physician about your other health conditions and medications (including all the prescription, non-prescription medications, nutritional supplements i.e. vitamins, minerals and herbal products). Refrain from taking aspirin or Ibuprofen at least 2 weeks before Orchiectomy. Stop smoking a few weeks before Orchiectomy to prevent healing problems during recovery period. Do not eat or drink any thing for at least 10 hours before the Orchiectomy surgery.

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What does the Orchiectomy procedure involve?

Orchiectomy is performed under general anesthesia, prior hospitalization may or may not be necessary. The lower abdomen and scrotum will be shaved and thoroughly cleaned before the operation. Either general anesthesia or local anesthesia with spinal block will be given to ensure that you do not experience any pain during the Orchiectomy procedure. Testicles will be removed through an incision in the scrotum or the groin. At the end of the Orchiectomy operation, the incision will be sutured. The surgery generally takes between 30 minutes and 1 hour. Your surgeon might suggest to insert a prosthesis (scrotal implant) or artificial replacement for the testes in your scrotum to give your scrotum a normal look. Some of the lymph nodes that are located deep in the abdomen or inguinal area may also be removed.

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What is the recovery period like following Orchiectomy?

You will spend a couple of days after Orchiectomy operation in the recovery room under observation to monitor your vital signs, heart and lung function and watch for excessive bleeding. Use ice for the first 24 hours followed by heat (at the site of operation) to relieve pain and swelling. Pain medication and antibiotics will be prescribed to prevent infection and alleviate pain and discomfort. You will be instructed to wear a scrotal support (jock strap) for 3 - 4 days and will be allowed to go home after 2 - 3 days. You will be ready to resume your daily activities in about a month and will be instructed to come in for regular follow up for the next 5 years if Orchiectomy was performed for the treatment of testicular cancer or prostate cancer. Keep your incision clean and dry, carefully clean the scrotal area when you bathe or shower and change your dressing.

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What is the outcome of Orchiectomy?

Orchiectomy is the treatment of choice for early testicular cancer. Prostate cancer is known to regress after surgical removal of testicles (Orchiectomy) as the source of testosterone is removed. The five year disease free survival rate is 95 - 97% in individuals with early testicular cancer. Orchiectomy is not a cure for prostate cancer however, it increases the rate of survival. When Orchiectomy is performed to remove early testicular cancer, it may completely eradicated the cancer without the need for adjuvant treatment like radiotherapy or chemotherapy. Of course you have to be vigilant and watch for the signs and symptoms of a recurring cancer.

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B . R . A . N . D . of Orchiectomy

Benefits of Orchiectomy

  • Orchiectomy is an effective way to remove testicular tumor and may or may not need chemotherapy or radiation therapy after the operation. Orchiectomy may relieve bone pain and may cause the prostate cancer to shrink.

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Risks of Orchiectomy

  • Reactions to general anesthesia
  • Infection
  • Bleeding
  • Infertility
  • Loss of libido
  • Erectile dysfunction
  • Breast enlargement (Gynecomastia)
  • Weight gain
  • Loss of muscle mass
  • Osteoporosis

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Alternatives to Orchiectomy

The indications for Orchiectomy are usually testicular cancer or advanced prostate cancer. Choosing not to have this surgery and exploring alternative options is certainly putting your self at increased health risk. Some of the alternatives to Orchiectomy include:

  • Using estrogen and progesterone (female hormones) to negate the effects of excessive testosterone production.
  • Medications that block the production or effects of male hormones.
  • Adjuvant therapies like chemotherapy, radiation therapy, hormonal therapy, or a combination of these treatments.

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Now or Never

  • Prosthetic implants are inserted in the scrotum at the time of Orchiectomy to maintain the natural appearance of the genitals. Removal of one testicle during Orchiectomy still enables you to have children and also to have erection during sexual intercourse.

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Decision to have Orchiectomy

  • If you are a candidate for Orchiectomy, then you should discuss your concerns about loss of sexual function and fertility with your physician before the operation. If you have pre-existing fertility problems, or if there is a chance that performing unilateral Orchiectomy might lead to infertility, then you may want to ask your doctor about sperm banking or freezing sperm before the operation for use in the future. This precautionary measure will allow you to have children even if the surgical treatment causes loss of fertility.

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Keywords: Testicular Cancer, Scrotal Swelling, Male Sex Hormones, Testosterone, Male Infertility, Male Sex Organs, Testicular Tumours, Andropause, Osteoporosis, Erectile Dysfunction, Testosterone Replacement Therapy, Adjuvant Cancer Treatment, Scrotal Implant, Sperm Banking, Chemotherapy, Radiation Therapy, Hormonal Therapy

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