ORCHIDECTOMY (SIMPLE OR RADICAL REMOVAL OF THE TESTICLE) AN INFORMATION LEAFLET Written by: Department of Urology May 2011 Stockport Tel: 0161 419 5698 Website: www.stockport.nhs.uk Tameside Tel: 0161 922 6696/6698 Website: www.tameside.nhs.uk Macclesfield Tel: 01625 661517 Orchidectomy 1 of 6
What Is Orchidectomy? Orchidectomy is the surgical removal of the testicle. A simple orchidectomy means that only the testicle will be removed, although if the operation is being carried out due to cancer, a radical orchidectomy will usually be performed (which means that the tissues around the testicle may also be removed e.g. lymph nodes, seminal vesicles). The operation is usually carried out under a general anaesthetic (when you are put to sleep) and involves a small incision (cut) on the same side of the groin as the affected testicle or in the scrotum. The incision will then be stitched together and you are usually expected to stay in hospital for one night. If the testicle is to be removed due to cancer, a small biopsy of the unaffected testicle may also be taken during this procedure. This would involve a thin needle being passed through the skin of the scrotum into the testicle, from where a small sample of cells are taken and sent to the laboratory to test for signs of cancer. You may also require further investigations in the form of scans, x-rays and/or blood tests. What Are The Benefits? An orchidectomy may be carried out to treat; Chronic testicular pain. Cancer of the testicle, to prevent spread of the disease. Are There Any Risks Involved? General Anaesthetic - you may feel normal soon after you wake, but you will be drowsy and your reactions sluggish for 24 to 48 hours. Bleeding There is a small risk of bleeding during the operation. Orchidectomy 2 of 6
Infection If the wound site appears reddened or inflamed, you notice a discharge (pus), or you have a temperature or feel feverish, you should visit your GP immediately as infection may be present, which may require antibiotics. Swelling and bruising You may find that the area around the operation site appears bruised and swollen and causes some discomfort. You should take painkillers when necessary. Altered body image Removal of the testicle from the scrotum would alter the appearance of your genital area. It is usually possible to have a prosthesis (false testicle) inserted at the time of the operation. You should discuss this with the Surgeon or Specialist Nurse at the pre-operative assessment clinic. Failure to Treat Symptoms of Pain If the operation is being carried out due to chronic pain in the scrotum, the results may be disappointing for you as the pain may still be present. Possibility of Requiring Further Treatment If the testicle is being removed due to cancer, further treatment in the form of chemotherapy or radiotherapy may be required. This is to prevent the cancer from coming back after surgery or to treat any cancer that has spread to other parts of the body. Radiotherapy and/or chemotherapy is carried out at the Christie Hospital, and as it may affect your fertility, the staff at the Christie will discuss the possibility of sperm-banking before any treatment is given. What Are The Alternatives? Orchidectomy is usually the first treatment for testicular cancer and allows for an exact diagnosis, as the tissue removed can be sent to the laboratory to determine the type of cancer, how aggressive it is and whether or not it has spread to other parts of the body. As previously mentioned, chemotherapy and radiotherapy can be given to treat testicular cancer but are usually used in conjunction with surgery to prevent the cancer coming back or to treat any spread of cancer. Other forms of pain management should be explored prior to undergoing an orchidectomy as a form of pain relief. Orchidectomy 3 of 6
What Happens To Me When I Arrive On The Ward? You will usually come into hospital on the day of your operation. You will meet the nursing staff who will be looking after you and an anaesthetist, who will discuss your options for pain relief following the operation and also talk to you about the anaesthetic you will have. On the Day of the Procedure Your operation will be performed at Stepping Hill Hospital, Stockport. It will be necessary to stop eating and drinking for several hours prior to the orchidectomy operation and this will be explained to you when you attend for a pre-operative assessment some weeks before the operation. If you would normally take tablets during this time, please ask at the preoperative assessment clinic which you should continue to take. Before going to the operating theatre, you may be asked to take a bath or shower and change into a theatre gown. Any jewellery (except your wedding ring), dentures and contact lenses must be removed. What Happens After The Procedure? You may have a dressing over your wound, which should remain in place until you are advised to remove it by the nursing staff. If you have any discomfort, you should request painkillers from the nurses looking after you. You should be able to eat and drink, as soon as you feel well enough and are over the effects of the anaesthetic. Orchidectomy 4 of 6
You will be encouraged to move around as early as possible, to prevent problems of reduced mobility (for example development of blood clots). Discharge Arrangements It is important that in the first twenty four hours of having had a general anaesthetic you should avoid: Being left in the house alone, or looking after young children Driving (it is advisable to check with your insurance company as to how long your insurance is invalid following a general anaesthetic) Operating machinery; this includes cookers and other domestic appliances. Making any important decisions or signing any legal documents Drinking alcohol It is advisable to wear supportive underwear for the first week following the operation. If your stitches need to be removed, you will be given information on when to attend your practice nurse at your GP s surgery, for their removal. Any necessary follow-up outpatient appointments will be arranged with your local urology clinic and sent to you via a letter to your home address. Day To Day Living You can resume normal activities about two weeks after the operation but should rest, should you feel the need to. There are no restrictions to taking daily baths or showers. The removal of a testicle should not affect a man s sex life or his ability to have erections. You can Orchidectomy 5 of 6
resume sexual activity when your wound has fully healed and you feel physically able to. The operation should not affect your ability to father children, although your fertility may be affected if you have testicular cancer. If There is a Problem If you experience any problems following discharge from hospital, please contact your GP. Other Useful Contacts or Sources of Information Cancer Backup Bath Place Rivington Street London EC2A 3JR Tel - 0808 8001234 (freephone information line, Monday to Friday, 9am to 7pm) www.cancerbackup.org. uk (provides information on all aspects of cancer and its treatment and on practical and emotional problems of living with cancer) Greater Manchester and Cheshire NHS Cancer Network website www.gmccn.nhs.uk (website with information about all aspects of cancer and details of support for people affected by cancer). If you have any questions you want to ask, you can use this space below to make notes to remind you. Orchidectomy 6 of 6
Source In compiling this information leaflet, a number of recognised professional bodies have been used, including the British Association of Urological Surgeons. Accredited good practice guidelines have been used. If you have a visual impairment this leaflet can be made available in bigger print or on audiotape. If you require either of these options please contact the Health Information Centre on 0161 922 5332 If you would like any further information please telephone the Urology Nurse Specialists at your local Urology Department on: Stepping Hill 0161 419 5695 Tameside 0161 922 6696/6698 Macclesfield 01625 661517 Orchidectomy 7 of 6
Author: Division/Department: Date Created: Reference Number: Version: Urology Department Elective Services June 2009 Version 1.1 Orchidectomy 8 of 6