radical orchidectomy

What is involved in the radical oechidectomy procedure?

radical orchidectomy main points

Key Points:

When faced with suspected testicular cancer, various treatment options are available to address the unique characteristics of each case. Understanding these options is crucial for informed decision-making and effective cancer management.

• Orchiectomy:

  • Radical removal of the testicle is the standard procedure for suspected testicular cancer.

  • Complete removal allows for a precise assessment of any suspicious areas, reducing the risk of missing cancer with small biopsies.

• Additional Treatments:

  • Removal of the testis may be sufficient in some cases, but chemotherapy or radiotherapy may be necessary for others.

  • Chemotherapy is particularly effective against certain types of testicular cancer, while radiation therapy targets cancer cells in specific areas.

• Fertility Considerations:

  • Testicular cancer and its treatments can impact fertility; hence, sperm banking before treatment is advisable.

• Cosmetic Reconstruction:

  • For those concerned about appearance, a testicular prosthesis (implant) can be inserted during the operation, providing a cosmetic option after testicle removal.

surgery

What occurs on the day of the procedure?

A/Prof Homi Zargar will discuss the surgery once again to ensure your understanding and obtain your consent. An anaesthetist will meet with you to explore the options of a general or spinal anaesthetic and discuss post-procedure pain relief.

Details of the procedure:

• The procedure is typically performed under general anaesthesia for comfort and well-being.

• Before the surgery, a careful check for allergies is conducted, and if necessary, an injection of antibiotics into a vein may be administered.

• The affected side is marked, imaging is checked, and the site will be confirmed with the patient at multiple stages.

• Your testicle is removed through an incision in the groin.

• If you opt for a prosthesis (implant), it is usually inserted through the same incision.

• However, in cases of significant bleeding or operative challenges, implantation may be deferred to a subsequent procedure to minimize infection risks.

• The wound is closed with absorbable stitches, eliminating the need for removal, and typically dissolves within two to three weeks.

• Provisions are made for careful wound management to promote optimal healing and minimize complications.
  

After-Effects and Risks of the Procedure:

• Almost all patients experience temporary swelling and bruising of the scrotum following the procedure.

• Around 20% of patients may express dissatisfaction with the final cosmetic result, particularly if a testicular prosthesis is implanted.

• Between 1 in 2 and 1 in 10 patients may encounter variations in the size and consistency of the implanted prosthesis compared to the other testicle.

• Between 1 in 2 and 1 in 10 patients may feel the fixation stitch for the implant through the scrotal skin.

• For between 1 in 10 and 1 in 50 patients, removal of the testicle alone may not cure testicular cancer.

• Similar proportions may require further treatments like radiation, chemotherapy, or additional surgery.

• The risk of hospital-acquired infection, including MRSA or Clostridium difficile, ranges between 4% and 6%, potentially higher for high-risk groups.

• Between 1 in 10 and 1 in 50 patients may experience incision infection, requiring additional treatment and possibly removal of the testicular prosthesis.

• Between 1 in 10 and 1 in 50 patients may face fertility loss as a result of surgery and any subsequent treatments, such as chemotherapy.

• Between 1 in 10 and 1 in 50 patients may face unknown long-term risks associated with the use of silicone products in the procedure.