2024-03-12 16:30:33
Definition: what is orchiectomy or removal of the testicle?
L‘orchidectomie also called radical inguinal orchidectomy is a intervention chirurgicale which consists of removing an entire testicle in men (total orchidectomy). Indeed, it is not possible to remove a single part of a testicle (partial orchiectomy).
This operation is the first-line treatment for testicular cancer. It is performed regardless of the stage of this cancer. Moreover, this ablation makes it possible to clarify the diagnosis. This surgery can be supplemented with chemotherapy (before or after it). Doctor Antoine Faix, urologist.
Fortunately, it is possible to live with only one testicle : one testicle is generally sufficient to produce the quantity of sperm necessary for procreation. Having only one testicle left does not cause a testosterone deficiency. The cells of the remaining testicle are put to greater use and increase their hormone production.
“However, if the patient is afraid of being aesthetically bothered, he can ask to place a testicular prosthesis at the time of ablation or subsequently. This decision is up to the medical team,” underlines the practitioner.
What is a testicle?
THE testicles are two organs of the male reproductive system that measure 4 to 6 centimeters. They are contained in an external pocket located at the front of the perineum, called scrotum or bourse. The testes produce sperm, male gametes essential for reproduction. They also produce the main male hormone testosterone (androgen).
What is testicular cancer?
Testicular cancer is far from common. He strikes in France 2,300 men per year. It can occur at any age, but it mainly affects young men (aged 15 to 45). The prognosis of this cancer is favorable thanks to the systematic ablative surgery and to the chemotherapy. However, chemotherapy can be heavy and leave after-effects.
Indications: why do an orchiectomy?
Orchiectomy (or radical inguinal orchiectomy) is the first-line treatment of testicular cancer whatever its stage. This surgery is performed as part of the processus diagnostic.
Sometimes, however, chemotherapy is offered before radical inguinal orchiectomy. But most of the time, complementary or second-line treatments are done during or after the intervention. This could be:
and retroperitoneal lymph node dissection (the surgeon removes the lymph nodes located in the back part of the abdomen called the retroperitoneum); a chemotherapy : it can be serious and require hospitalization; a salvage surgery after chemotherapy (in case the testicular cancer does not fully respond to chemotherapy administered after the orchiectomy); a metastasis surgery on one or more other organs (such as the lungs, mediastinum, liver, brain, etc.) if the cancer has spread.
Procedure: how is the removal of a testicle carried out?
“Testicular ablation is not a major intervention. It takes place under General anaesthesia or locoregional and only lasts between 20 and 30 minutes in the operating room”, according to the practitioner.
To remove the testicle, the surgeon goes through wool through a simple small incision. It removes the spermatic cord and the scrotum through this opening. Sometimes the doctor removes both testicles (bilateral orchiectomy) if he fears that the second organ may also be affected by cancer.
How to prepare for the procedure?
A hospitalization for a few days is to be planned for this intervention, you should therefore organize your schedule accordingly.
A pre-anesthesia consultation is mandatory in the days before the operation in order to check that there are no contraindications to anesthesia and in order to select the most suitable mode of anesthesia (spinal anesthesia, epidural, general anesthesia, etc.). ).
Before the procedure, the patient must:
to be fasting et avoid tobacco within 6 hours before the procedure; stop certain medications if requested by the doctor. Conversely, it is possible that certain medications are administered before the procedure.
What are the side effects and risks of complications after this surgery?
Orchiectomy is a low-risk operation with most often minor side effects related to the ablation or general anesthesia.
Surgery may cause the following side effects:
of the local pain in the short term; sensitivity or on the contrary loss of sensitivity of the operated area ; l’surgical wound infection ; l’hematoma (accumulation of blood in the wound) or bruises ;of the nausea and vomiting.
Total or partial recovery occurs within a few months.
Rarely, surgery can be complicated by general infection, delayed healing, or significant bleeding.
Some patients complain of sexual disorders or report fertility disorders.
Orchiectomy and prosthesis
It is possible to replace the removed testicle with a testicular prosthesis, especially in young patients concerned about being embarrassed on an aesthetic level. It is possible to insert this artificial testicle during the ablative operation or during a subsequent intervention.
The artificial testicle perfectly imitates the old testicle (weight, shape, etc.). “However, this silicone prosthesis has no hormonal action and does not produce sperm,” warns the practitioner.
Please note, it is not always possible to have a testicular prosthesis fitted, talk to your doctor.
Orchiectomy and fertility
Removal of a testicle may reduce (at least temporarily) your fertility. If you have a parental plan, it is therefore recommended to keep sperm samples before removing the testicle. Talk to your doctor.
Orchiectomy: how much does it cost?
The price of orchiectomy for the treatment and diagnosis of testicular cancer is around 120 euros. This medical procedure is 100% covered by social security without any advance costs. Additional fees are possible depending on the choice of the medical team.
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