What is an orchidectomy?

An orchidectomy is a surgical intervention aimed at the removal of one or both testicles. The testicles, two small organs situated within the scrotum (a skin sac below the penis), play a crucial role in sperm production and the secretion of male hormones, including testosterone.

Medical professionals perform orchiectomies for various reasons, such as treating or preventing testicular cancer, prostate cancer, and male breast cancer. Additionally, transgender women undergoing the process of transitioning from male to female may opt for an orchidectomy. Typically, this procedure is performed on an outpatient basis, allowing patients to return home on the same day.

When is an orchidectomy indicated?

Orchidectomy may be indicated for the following purposes:

• Treating cancer: Orchidectomy serves as the initial step in both the diagnosis and treatment of testicular cancer. Removing primary cancer enables pathologists to examine the tissue for diagnostic purposes. This procedure is also utilised as a treatment option for male breast cancer and prostate cancer. Certain cancer cells are stimulated to grow by androgens, which are male hormones like testosterone. By eliminating the testes, hormone levels decrease, leading to tumour shrinkage as the supply of male hormones supporting their growth is cut off.
• Assisting transgender individuals in their transition: As a component of the transitioning process, many transgender women (or trans women) opt for an orchidectomy. Dr Singh may perform this procedure as a standalone surgery or as part of a comprehensive gender affirmation surgery. Alongside physical transformations, an orchidectomy significantly reduces the levels of male hormones within the body.
• Removing damaged testicles: Sports injuries, motorcycle accidents, and other forms of trauma can result in severe damage to the testicles. If a healthcare provider is unable to repair the injured testicle, they may opt to remove it and suture the surrounding tissues. In rare cases, the removal of an undescended testicle may be necessary.

How is an orchidectomy performed?

During the orchidectomy procedure, the urologist will begin by cleansing the area and creating an incision, the specific location of which depends on the technique being employed. The incision can be made either in the pubic area (inguinal orchidectomy) or in the scrotum (simple orchidectomy). The extent of the removal may vary, including:

• Both testicles (bilateral orchidectomy).
• One testicle (unilateral orchidectomy).
• The testicles and the spermatic cord, known as a radical inguinal orchidectomy, are interconnected. The spermatic cord encompasses blood vessels and nerves, functioning as a pathway for the transportation of semen from the testicles to the penis.

If you choose to have a prosthetic testicle, the urologist will implant it within the scrotum. This prosthetic testicle is filled with saline (salt water). Upon completion of the procedure, the urologist will close the incision using stitches.