What is an orchidectomy?

During an orchidectomy, one or both testicles are surgically removed.

An orchiectomy or orchiectomy refers to the removal of one or both testicles in men. Either term means the same thing, but orchidectomy tends to be the most common name for the procedure in the UK. There are several reasons why this surgery may be necessary. Testicular cancer is a clear indication for orchiectomy, and some men may have unilateral or bilateral orchiectomy as a way to reduce testosterone that can exacerbate prostate cancer in advanced stages. Additional reasons why testicle removal may be necessary include severe traumatic injury to a testicle or personal preference for those undergoing sex reassignment therapy.

Some men undergo an orchidectomy as a way to reduce testosterone and fight prostate cancer.

It would be fair to say that, except for gender reassignment therapy, most men do not voluntarily undergo orchidectomy. It is comparable in producing anxiety to the way many women may feel when they need to have an oophorectomy (removal of the ovary) or hysterectomy (removal of the uterus). Especially if both testicles are removed, the fertility rate drops to zero, and men interested in having children should talk to their doctors about collecting sperm before the procedure. Testosterone decline can have minor to major effects on sexual interest, and cannot always be easily remedied. Low testosterone is often treated with testosterone supplementation, but if the reason for orchiectomy is to reduce testosterone levels, this treatment option may not be open.

There are several reasons why surgery to remove one or both testicles would be necessary.

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However, men should note that removing a single testicle may not be dramatic in its aftereffects. Fertility is still possible and the remaining testicle continues to produce testosterone and sperm. Many men remain virile, interested in sex and masculine as ever. One need only look at public examples of people who have had an orchidectomy, such as athlete Lance Armstrong, to be sure that removing a testicle may have little to do with masculinity, physical strength, or virility.

Weight gain is a possible side effect of an orchidectomy.

Talking with doctors before an orchidectomy is always valuable. Doctors can tell patients exactly how they plan to have this surgery, which can vary. Incisions may occur in the scrotum or groin, and all or part of the testicular gland may be removed. When testicular cancer is present, the most common procedure is an inguinal or radical orchidectomy, which accesses the testicles through the groin and removes a greater amount of spermatic cord and testicular tissue. The goal is to ensure that all cancerous tissue is removed as needed.

Low testosterone can lead to frequent bone fractures in men who have had an orchidectomy.

No surgery is risk-free, and in addition to some sexual function issues, men who undergo an orchidectomy may experience symptoms that include mood swings, weight gain, slight enlargement of breast tissue, or a feeling of fatigue. Again, some of the symptoms can be treated with hormones, if that doesn’t interfere with the cancer treatment. Men who have had radical orchiectomy for testicular cancer need to continue to be screened because there is some risk of the cancer returning. Those with prostate cancer also need careful medical follow-up.

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