Radical Orchidectomy

WHAT IS RADICAL ORCHIDECTOMY?

Radical Orchidectomy refers to the surgical removal of the testicle and the leash of blood vessels (called spermatic cord) leading to and from the testicle.

WHAT IS THE INDICATION FOR A RADICAL ORCHIDECTOMY?

The principle reason for a radical orchidectomy is when a diagnosis of testicular cancer has been made. Dr Vasudevan will have done all the appropriate tests and investigations to come to this diagnosis prior to scheduling the operation.

WHAT DOES A RADICAL ORCHIDECTOMY INVOLVE?

A radical orchidectomy is done under a general anesthetic in hospital. It will require an overnight stay in hospital.

You will be asked to fast for 6 hours prior to the procedure. When you arrive at the hospital, the nurses will admit you and get you prepared for the procedure.

Prior to you being taken to the operating room and with you fully awake, Dr Vasudevan will confirm with you the testicle that needs to be removed. Dr Vasudevan will also place a mark on the testicle so that both of you are certain and agree that the correct testicle is going to be removed.

You will be taken to the operating room when your turn for the procedure has arrived.

The anesthetist will give you medications to get you off to sleep completely. Once you are asleep Dr Vasudevan will clean the required area with anti-septic solution such as betadine. An incision is then done in the groin on the same side as the testicle to be removed. The leash of blood vessels (spermatic cord) that runs to and from the testicle in this area is identified and clamped. The testicle to be removed is then delivered from the scrotal sac to the groin wound. Once this is done both the testicle and the spermatic cord are removed together.

The testis and cord are then sent to the laboratory for further analysis.

The spermatic cord that is clamped is tied off with sutures. The groin wound is also closed in 2 layers with appropriate dissolvable sutures.

Once the procedure has been completed you will be taken to the recovery area, where you will be kept under observation till you are fully awake.

Once fully awake, you will be taken to the ward. Dr Vasudevan will review you the following day and if you are feeling well, you will be discharged home.

WHAT CAN YOU EXPECT AFTER THE PROCEDURE?

When you get home you can perform your daily chores, however it is recommended that you do not engage in vigorous or strenuous activity for 3 to 4 weeks.

It is normal to have some tenderness to the incision site and scrotum for a week or two  after the procedure. Simple pain killers such as paracetamol may be needed to reduce the discomfort.

You may also notice some bruising or mild swelling in the groin or scrotum. This is normal and will resolve in a couple of weeks.

WHAT ARE THE COMPLICATIONS OF A RADICAL ORCHIDECTOMY?

While complications are rare, they may include:

  • Infection to the wound – If you are feeling feverish or unwell and notice some swelling, discharge or redness to the wound then then may suggest that it is infected. Antibiotics will be needed to treat this.
  • Bleeding – Significant or sudden swelling to the groin and scrotal area may signify bleeding and hence hematoma formation. If this occurs please return back to the hospital. If the bleeding is assessed to be mild then it can be treated conservatively. However, if the bleeding is extensive then a return back to theatre will be needed to stop the bleeding and evacuate the hematoma.
  • Numbness to the scrotum and inner thigh – If the nerve that runs in the groin has been bruised then it can cause numbness to the scrotal and thigh area. The numbness may resolve gradually and generally takes many months to do so.
  • Hernia formation – A swelling may occur in the groin area many months after the surgery has been completed. This may suggest a hernia due to weakness of the muscles in the groin area. If this occurs then surgery may be needed to rectify the hernia.

FOLLOW-UP WITH DR VASUDEVAN

Dr Vasudevan will review you in his office 2 to 3 weeks after the completion of surgery.

During this consultation he will review the wound in the groin and will also discuss the pathology results of the testicle that has been removed.

It is common for further treatment such as chemotherapy to be needed. As such Dr Vasudevan will refer you to the medical oncologist for further assessment and treatment as needed.