Table of ContentsView AllTable of ContentsWhat Is Orchiectomy?TypesWhy It’s NeededPreparationRecoveryLong-Term Effects
Table of ContentsView All
View All
Table of Contents
What Is Orchiectomy?
Types
Why It’s Needed
Preparation
Recovery
Long-Term Effects
Anorchiectomy(also calledorchidectomy) is the removal of one or both of thetesticles.
It may be necessary to remove a testicle to prevent or stop the spread of certain types of cancer. In some instances, testicular injury requires an orchiectomy. Removal of the testicles is also one of several procedures performed for transgender women.
This article explains why an orchiectomy may be needed and how it is performed. If covers preparing for the surgery and what you should know about recovery and sexual function following the removal of one or both testicles.
The testicles, or testes, are egg-shaped organs enclosed within the scrotum surrounding the penis. These organs producespermas well as the sex hormonetestosterone.
The removal of one or both testes via an orchiectomy may be needed to treat a variety of congenital defects, such as an undescended testicle, or medical conditions, such astesticular cancer.
These procedures can affect male fertility and testosterone levels. Additional medical treatments may be needed to manage those complications.
An orchiectomy is also performed as part of feminizing genital surgery.
What Are the Types of Orchiectomy?
An orchiectomy is typically performed on an outpatient basis, and it typically takes 30 minutes to one hour to perform. There are several different types of orchiectomies. The type of procedure depends on the medical condition being treated and what the treatment goal is.
There are two types of procedures used to remove the testicles:
A radical orchidectomy may be performed if there is even thesuspicionof testicular cancer (such as when a lump is discovered in the testicle). This method is usually chosen in lieu of a biopsy because a tissue biopsy may cause cancer cells to spread.
Depending on the circumstances, your surgeon may perform a bilateral (removal of both testes) or single orchiectomy.
Partial Orchiectomy
In some situations, your surgeon may suggest a partial orchiectomy, which removes some but not all of the testicle(s). A partial removal might be appropriate in instances where loss of fertility or testosterone is a concern and cancer can be removed.
Preserving FertilityAnother option to address fertility concerns is sperm cryopreservation, in which sperm is collected, frozen, and stored for later fertilization. Consult with a male reproductive urologist about these options.
Preserving Fertility
Another option to address fertility concerns is sperm cryopreservation, in which sperm is collected, frozen, and stored for later fertilization. Consult with a male reproductive urologist about these options.
Who Should Get an Orchiectomy?
An orchiectomy is performed for many different reasons. The most common reason is concern for testicular cancer or treatment for advanced prostate cancer.However, the following diseases, disorders, and congenital conditions may also require the removal of the testes.
Testicular Cancer
If a tumor is identified in the testicular area, your healthcare provider will recommend a removal of the tumor and the entire testicle as well as the spermatic cord and surrounding blood and lymph vessels. This may seem extreme, but trying to remove just the tumor or attempting a biopsy poses a significant risk of the cancer spreading.
Prostate Cancer
Theprostate glandis a part of the male reproductive system. There are usually no symptoms in the early stages ofprostate cancer, so it may not be discovered until it has spread.
To stop the further spread of prostate cancer, a bilateral orchiectomy can be performed. This is considered a type of hormone therapy, known as androgen deprivation because once the testicles are removed, the level of testosterone drops rapidly.This helps to stall the spread of prostate cancer.
If cancer is diagnosed following an orchiectomy, further tests and treatment will be needed. Lab tests to monitor blood will be required for several years, even if all the cancer was removed. If there is a high risk of the cancer coming back, chemotherapy and other cancer treatments may be ordered.
Testicular Torsion
Testicular torsionis a rare condition in which one or both testes twist around the spermatic chord. This can occur in babies, young boys, or grown men. Those born with testicles that are not well attached to the scrotum are at risk for this problem.
The lack of attached tissue means that the testes can move, which can result in torsion. This can happen while standing, sitting, or sleeping.
Symptoms include:
This is a medical emergency. If treated immediately, you may be able to avoid having to have an orchiectomy. Without treatment,necrosis(death) to the tissues of the testicles can occur.
Injury
Severe force to the testicles can result in a rupture of the tissue around the testicles. In very rare cases this can cause damage to the testes that is so serious it requires removal. However, doctors will attempt other surgical solutions before deciding on an orchiectomy.
Breast Cancer
A simple orchiectomy used to be a common treatment for male breast cancers. Removal of the testes regulates hormones and can shrink most male breast cancers. However, this treatment is less common today because medications that lower androgen levels can effectively provide the same results.
Undescended Testicle
Male babies are usually born with both testicles fully descended into the scrotum. Sometimes this doesn’t occur until after birth. If it doesn’t happen within the early years of life, anorchiopexyis usually performed. In this procedure, a surgeon moves the testicle into the scrotum.
If this problem is not treated before puberty, it can create complications. The testicle will not be functional and carries a high risk for testicular cancer.At that point, the testicle that has not descended will need to be removed via a radical orchiectomy.
Transfeminine Transition
An orchiectomy might be done as a first step during atranswomen’s surgical transition. As a stand-alone procedure, it can reduce the level of testosterone in the body. However, most individuals undergoing a transfeminine transition choose to also have apenectomy(penis removal) along with urethral shortening,vulvoplasty, andvaginoplasty
How to Prepare
Before having an orchiectomy, a physical exam and blood work are needed to ensure good health before undergoing the procedure.
Inform the healthcare provider of any medications you are taking (including over-the-counter medications, vitamins, and supplements). In addition, tell them about any prior issues or current concerns with fertility or low testosterone (energy, libido).
The type of anesthesia that may be used during an orchiectomy includes either a general type of anesthesia (where the person is unconscious) or a spinal block (the person is awake, but does not have any sensation from the waist down during the procedure).
Arrange in advance for a ride home after the procedure as you will not be able to drive or operate machinery until the effects of the anesthesia have worn off.
Should I Get a Prosthesis?A testicular prosthesis is often used to maintain the normal look and feel of the testicle that has been removed. It’s made of silicone and filled with saline to give it a soft and natural feel.The decision to have a prosthetic implant is a personal one. Discuss the option with a urologist or other healthcare provider before getting an orchidectomy.
Should I Get a Prosthesis?
A testicular prosthesis is often used to maintain the normal look and feel of the testicle that has been removed. It’s made of silicone and filled with saline to give it a soft and natural feel.The decision to have a prosthetic implant is a personal one. Discuss the option with a urologist or other healthcare provider before getting an orchidectomy.
A testicular prosthesis is often used to maintain the normal look and feel of the testicle that has been removed. It’s made of silicone and filled with saline to give it a soft and natural feel.
The decision to have a prosthetic implant is a personal one. Discuss the option with a urologist or other healthcare provider before getting an orchidectomy.
Post-Op Care
Ice will also help with any pain you are experiencing. After a few days of keeping the incision area dry, you will be able to wash it gently in the bath. Your healthcare provider may prescribe you medications for pain and ointments to promote healing; take these as directed.
Further Post-Surgical Instructions
It can take up to two months for complete recovery from orchiectomy surgery, and there are several things you can expect as part of the aftercare plan.
You will most likely be going home just a few hours after the procedure and will return the next day or soon thereafter for a follow-up appointment. Expect to take a few days off of work to recuperate. You also need to limit physical activity such as exercise, sex, sports, and running for a month after the surgery (or for however long your healthcare provider advises).
In addition:
Complications
Notify your healthcare provider immediately if complications are noticed after surgery. These may include redness, pus, or bleeding from the incision site, severe pain or loss of feeling around the scrotum, and a fever (over 100 degrees Fahrenheit).
In addition, you may notice a hematoma (a large purple area on the scrotum which indicates there is blood in that area), or an inability to urinate. Again, contact your healthcare provider if you notice any of these complications.
Because the testicles are the primary source of testosterone in the body, lower testosterone can occur after orchiectomy. If testosterone is low, there are several long-term side effects that may occur. These are more pronounced if both testicles are removed or if you are simultaneously undergoing chemotherapy.
Side effects include:
Sexual Function
If you have had one testicle removed, your sexual function should not be affected as long as your remaining testicle is producing adequate amounts of testosterone. You should have these levels checked regularly. Testosterone can be replaced or increased with medication if needed.
Can I Still Get Hard After an Orchiectomy?Barring other issues, this shouldn’t be a problem after removal of one testicle.After a bilateral orchiectomy, your body will not be producing testosterone in the testicles. While small amounts will be produced in the adrenal gland, you will need hormone replacement therapy to maintain an erection.
Can I Still Get Hard After an Orchiectomy?
Barring other issues, this shouldn’t be a problem after removal of one testicle.After a bilateral orchiectomy, your body will not be producing testosterone in the testicles. While small amounts will be produced in the adrenal gland, you will need hormone replacement therapy to maintain an erection.
Barring other issues, this shouldn’t be a problem after removal of one testicle.
After a bilateral orchiectomy, your body will not be producing testosterone in the testicles. While small amounts will be produced in the adrenal gland, you will need hormone replacement therapy to maintain an erection.
In some situations (such as with prostate cancer), a urologist will be consulted to decide whether testosterone replacement is safe.
Fertility
If you have a unilateral orchiectomy (one testicle removed), your fertility and the testosterone level in your body should not be affected as long-term as your other testicle is healthy and working properly.
Only one testicle is required to produce semen and sperm cells; however, studies have shown that after testicular torsion, one-third of men have a lower sperm count. Testicular torsion can also adversely affect how the sperm moves (which could lower fertility), but this is rare.
What Is Testosterone Replacement Therapy?
Summary
A radical orchiectomy is the standard treatment for testicular cancer. It may also be necessary for other conditions including the failure of a testicle to descend before puberty, testicle torsion, or as part of the surgical steps required for a transwoman’s medical transition.
A simple orchiectomy, which is less invasive, may be used for minor injuries or other less serious conditions.
As an outpatient day surgery, you can expect to be sent home the same day as the procedure. recovery can take months, though, It’s important to avoid straining muscles in the area of your groin and to take care of the incision.
If testing of the tissue shows cancer, your healthcare provider may prescribe additional treatments including chemotherapy.
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Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Anderson E, Pascoe C, Sathianathen N, Katz D, Murphy D, Lawrentschuk N.Subinguinal orchiectomy-A minimally invasive approach to open surgery.BJUI Compass. 2020;1(5):160-164. doi:10.1002/bco2.33Johns Hopkins.Radical orchiectomy.Johns Hopkins Medicine.Partial orchiectomy.Cancer Research UK.Surgery to remove your testicles (orchidectomy).Michigan Medicine.Orchiectomy for testicular cancer.American Cancer Society.Surgery for testicular cancer.Atta MA, Elabbady A, Sameh W, Sharafeldeen M, Elsaqa M.Is there still a role for bilateral orchidectomy in androgen-deprivation therapy for metastatic prostate cancer?.Arab J Urol. 2019;18(1):9-13. doi:10.1080/2090598X.2019.1690270Urology Care Foundation.What is testicular torsion?American Cancer Society.Hormone therapy for breast cancer in men.Gupta V, Giridhar A, Sharma R, Ahmed SM, Raju KVVN, Rao TS.Malignancy in an undescended intra-abdominal testis: A single institution experience.Indian J Surg Oncol. 2021;12(1):133-138. doi:10.1007/s13193-020-01262-9van der Sluis WB, Steensma TD, Bouman MB.Orchiectomy in transgender individuals: A motivation analysis and report of surgical outcomes.Int J Transgend Health. 2020;21(2):176-181. doi:10.1080/26895269.2020.1749921Cleveland Clinic.Orchiectomy.MyHealth.Alberta.ca.Orchiectomy: Before your surgery.Cancer Research UK.Surgery to remove the testicles.Urology Care Foundation.Testicular torsion frequently asked questions.Additional ReadingCancer Research UK staff.Testicular Cancer, Removing a testicle (orchidectomy).Cancer Research UK.John Hopkins Medicine staff.Partial Orchiectomy. John Hopkins Medicine Health Library.Orchid staff.Testosterone Replacement. Orchid-cancer.org.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Anderson E, Pascoe C, Sathianathen N, Katz D, Murphy D, Lawrentschuk N.Subinguinal orchiectomy-A minimally invasive approach to open surgery.BJUI Compass. 2020;1(5):160-164. doi:10.1002/bco2.33Johns Hopkins.Radical orchiectomy.Johns Hopkins Medicine.Partial orchiectomy.Cancer Research UK.Surgery to remove your testicles (orchidectomy).Michigan Medicine.Orchiectomy for testicular cancer.American Cancer Society.Surgery for testicular cancer.Atta MA, Elabbady A, Sameh W, Sharafeldeen M, Elsaqa M.Is there still a role for bilateral orchidectomy in androgen-deprivation therapy for metastatic prostate cancer?.Arab J Urol. 2019;18(1):9-13. doi:10.1080/2090598X.2019.1690270Urology Care Foundation.What is testicular torsion?American Cancer Society.Hormone therapy for breast cancer in men.Gupta V, Giridhar A, Sharma R, Ahmed SM, Raju KVVN, Rao TS.Malignancy in an undescended intra-abdominal testis: A single institution experience.Indian J Surg Oncol. 2021;12(1):133-138. doi:10.1007/s13193-020-01262-9van der Sluis WB, Steensma TD, Bouman MB.Orchiectomy in transgender individuals: A motivation analysis and report of surgical outcomes.Int J Transgend Health. 2020;21(2):176-181. doi:10.1080/26895269.2020.1749921Cleveland Clinic.Orchiectomy.MyHealth.Alberta.ca.Orchiectomy: Before your surgery.Cancer Research UK.Surgery to remove the testicles.Urology Care Foundation.Testicular torsion frequently asked questions.
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