Orchiectomy

Overview

The surgical removal of one or both testicles.

Indications

There are many reasons why a testicle may require removal. Some of those reasons are: benign and malignant tumors, trauma to the testicle, an undescended testicle that is atrophic.

Procedure

There are two approaches that can be taken to remove a testicle. An inguinal approach means an incision is made in the groin area (similar to a hernia incision). This approach is used when looking for an undescended testicle, if the testicle is found to be viable it will be brought down to the scrotal area and tacked in place with sutures. This is called an orchiopexy. If the testicle is not found to be viable (atrophic) it is removed, this is an orchiectomy. This approach is also used when cancer is present so that the spermatic cord, which is attached to the testicle, can also be removed. The other approach is to make an incision in the scrotum and remove just the testicle.

Post-Operative Instructions

Diet

You may return to your normal diet within 24 hours following your surgery. You may note some mild nausea and possibly vomiting the first 6-8 hours following surgery. This is usually due to the side effects of anesthesia, and will subside quite soon. We suggest clear liquids and a light meal the first evening following surgery.

Activity

Physical activity should be restricted the first 48 hours. During this time you should remain relatively inactive, moving about only when necessary. During the first few days following surgery you should avoid lifting heavy objects (anything greater than 15 pounds), and avoid strenuous exercise. If you are employed, ask us specifically about your restrictions for both home and work. We will write a note to your employer if needed.

You should plan to wear a tight pair of briefs or an athletic supporter for the first 4-5 days, even while sleeping. This will keep the scrotum immobilized to some degree and keep the swelling down. Ice packs should be placed over the scrotum the first 48 hours. Ice is a good pain reliever and keeps the swelling down. Fifteen minutes on and 15 minutes off is a reasonable schedule. Frozen peas or corn in a Ziploc® bag can be frozen, used, and refrozen.

Wound Care

In most cases, your incision will have absorbable sutures that dissolve within the first 10-20 days. Some may fall out even earlier. Expect some redness as the sutures dissolve, but this should occur only around the sutures. If there is generalized redness, especially with increasing pain or swelling, let your doctor’s medical assistant know. The scrotum will very likely get black and blue as blood spreads in the tissues. Sometimes the entire scrotum will turn colors. Black and blue is followed by a yellow and brown color. In time, this coloration will go away.

Hygiene

You may shower 48 hours after surgery. Tub bathing should be restricted until the seventh day.

If the pain is not too bad, you may take Tylenol (acetaminophen) or Advil (ibuprofen), which contain no narcotic agents and might be tolerated a little better with fewer side effects. If the pain medication you are sent home with does not control the pain, please contact your doctor.

Problems you should report to your urologist:

• Fever over 100.5 degrees Fahrenheit
• Moderate or fever swelling
• Drug reaction such as hives, rash, and nausea or vomiting