What is an Orchiectomy

Orchiectomy is the removal of one or both testicles. It is most often done to treat cancer of the prostate or testicles. It may be done in men with breast cancer, or to prevent cancer in men whose testicles did not develop normally.

An orchiectomy may also be needed when an injury to a testicle cannot be repaired. The testicles can be replaced with artificial testicles (prosthesis).

Tell a health care provider about:

• Any allergies you have.
• All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
• Any problems you or family members have had with anesthetic medicines.
• Any blood disorders you have.
• Any surgeries you have had.
• Any medical conditions you have.

What are the risks?

• Infection of the surgical site.
• Bleeding inside the sac that holds the testicles (scrotum). This is called a scrotal hematoma.
• Discharge from the surgical site.

What happens before the procedure?

Staying hydrated

Follow instructions from your health care provider about hydration, which may include:

• Up to 2 hours before the procedure – you may continue to drink clear liquids, such as water, clear fruit juice, black coffee, and plain tea.

Eating and drinking restrictions

Follow instructions from your health care provider about eating and drinking, which may include:

• 8 hours before the procedure – stop eating heavy meals or foods such as meat, fried foods, or fatty foods.
• 6 hours before the procedure – stop eating light meals or foods, such as toast or cereal.
• 6 hours before the procedure – stop drinking milk or drinks that contain milk.
• 2 hours before the procedure – stop drinking clear liquids.

General instructions

• Ask your health care provider about:
  • Changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines or blood thinners.
  • Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood. Do not take these medicines before your procedure if your health care provider instructs you not to.
• You may be given an oral antibiotic medicine. Ask your health care provider about taking this medicine with a sip of water on the morning of the procedure.
• You may be asked to wash your genital area with germ-killing soap the morning of your procedure.
• Plan to have someone take you home from the hospital or clinic.

What happens during the procedure?

• To reduce your risk of infection:
  • Your health care team will wash or sanitize their hands.
  • Your skin will be washed with soap.
  • Hair may be removed from the surgical area.
• An IV tube will be inserted into one of your veins. You will be given one or more of the following:
  • A medicine to help you relax (sedative).
  • A medicine to numb the area (local anesthetic).
  • A medicine to make you fall asleep (general anesthetic).
• This procedure may involve removal of one or both testicles. The steps for the procedure will depend on the reason for the procedure.
  • If your procedure is for treatment of prostate cancer:
    • A cut (incision) will be made in the scrotum.
    • The testicle will be removed through the incision in the scrotum.
    • A prosthetic filled with saline may be inserted to fill the space in the scrotum where the testicle was removed.
  • If your procedure is for treatment of testicular cancer:
    • A cut (incision) will be made in the groin.
    • The testicle and the spermatic cord will be removed through the groin incision.
    • A prosthetic filled with saline may be inserted to fill the space in the scrotum where the testicle was removed.
  • After the removal, the incision will be closed with stitches (sutures), skin glue, or adhesive strips.
  • A sterile bandage (dressing) will be applied to the incision site.

The procedure may vary among health care providers and hospitals.

What happens after the procedure?

• Your blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored until the medicines you were given have worn off.
• Once you are awake, stable, and taking fluids well, without other problems, you will be allowed to go home.
• You may have scrotal support. If the scrotal support irritates your incision site, you may remove the support.
• You will have a sterile dressing. It is okay if the dressing comes off, especially at night. Air will help a scab to form, which will eliminate the need for dressings during the day.
• Do not drive for 24 hours if you were given a sedative.

Summary

• Orchiectomy is a surgical procedure to remove one or both testicles.
• Orchiectomy is most often done to treat cancer of the prostate or testicles.
• A prosthetic filled with saline may be inserted to fill the space in the scrotum where the testicle was removed.

Orchiectomy, Care After

This sheet gives you information about how to care for yourself after your procedure. Your health care provider may also give you more specific instructions. If you have problems or questions, contact your health care provider.

What can I expect after the procedure?

After the procedure, it is common to have:

• Pain.
• Bruising.
• Blood pooling (hematoma) in the area where your testicles were removed.
• Depression or mood changes.
• Fatigue.
• Hot flashes.

Follow these instructions at home:

Managing pain and swelling

• If directed, put ice on the affected area:
  • Put ice in a plastic bag.
  • Place a towel between your skin and the bag.
  • Leave the ice on for 20 minutes, 2–3 times a day.
• Wear scrotal support as told by your health care provider.
• To relieve pressure and pain when sitting, you may use a donut cushion if directed by your health care provider.

Incision care

• Follow instructions from your health care provider about how to take care of your incision. Make sure you:
  • Wash your hands with soap and water before you change your bandage (dressing). If soap and water are not available, use hand sanitizer.
  • Change your dressing once a day, or as often as told by your health care provider. If the dressing sticks to your incision area:
    • Use warm, soapy water or hydrogen peroxide to dampen the dressing.
    • When the dressing becomes loose, lift it from the incision area. Make sure that the incision stays closed.
  • Leave stitches (sutures), skin glue, or adhesive strips in place. These skin closures may need to stay in place for 2 weeks or longer. If adhesive strip edges start to loosen and curl up, you may trim the loose edges. Do not remove adhesive strips completely unless your health care provider tells you to do that.
• Keep your dressing dry until it has been removed.
• Check your incision area every day for signs of infection. Check for:
  • More redness, swelling, or pain.
  • More fluid or blood.
  • Warmth.
  • Pus or a bad smell.

Bathing

• Do not take baths, swim, or use a hot tub until your health care provider approves. You may start taking showers two days after your procedure.
• Do not rub your incision to dry it. Pat the area gently with a clean cloth or let it air-dry.

Medicines

• Take over-the-counter and prescription medicines only as told by your health care provider.
• If you were prescribed an antibiotic medicine, use it as told by your health care provider. Do not stop using the antibiotic even if you start to feel better.
• If you had both testicles removed, talk with your health care provider about medicine supplements to replace one of the male hormones (testosterone) that your body will no longer make.

Driving

• Do not drive for 24 hours if you were given a medicine to help you relax (sedative).
• Do not drive or use heavy machinery while taking prescription pain medicines.

Activity

• Avoid activities that may cause your incision to open, such as jogging, playing sports, and straining with bowel movements. Ask your health care provider what activities are safe for you.
• Do not lift anything that is heavier than 10 lb (4.5 kg), or the limit that your health care provider tells you, until he or she says that it is safe.
• Do not engage in sexual activity until the area is healed and your health care provider approves. This could take up to 4 weeks.

General instructions

• To prevent or treat constipation while you are taking prescription pain medicine, your health care provider may recommend that you:
  • Drink enough fluid to keep your urine clear or pale yellow.
  • Take over-the-counter or prescription medicines.
  • Eat foods that are high in fiber, such as fresh fruits and vegetables, whole grains, and beans.
  • Limit foods that are high in fat and processed sugars, such as fried and sweet foods.
• Do not use any products that contain nicotine or tobacco, such as cigarettes and e-cigarettes. If you need help quitting, ask your health care provider.
• Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

• You have more pain, swelling, or redness in your genital or groin area.
• You have more fluid or blood coming from your incision.
• Your incision feels warm to the touch.
• You have pus or a bad smell coming from your incision.
• You have constipation that is not helped by changing your diet or drinking more fluid.
• You develop nausea or vomiting.
• You cannot eat or drink without vomiting.

Get help right away if:

• You have dizziness or nausea that does not go away.
• You have trouble breathing.
• You have a wet (congested) cough.
• You have a fever or shaking chills.
• Your incision breaks open after the skin closures have been removed.
• You are not able to urinate.

Summary

• After this procedure, it is most common to have bruising or blood pooling in the area where the testicles were removed.
• You should check your incision area every day for signs of infection, such as redness, swelling, pain, fluid, blood, warmth, pus, or a bad smell.
• Avoid activities that may cause your incision to open, such as jogging, playing sports, and straining with bowel movements. Ask your health care provider what activities are safe for you.
• You should not engage in sexual activity until the area is healed and your health care provider approves. This could take up to 4 weeks.
• Men who have both testicles removed may have emotional and physical side effects. Your health care provider can help you with ways to manage those side effects.