Radical Inguinal Orchiectomy
Radical inguinal orchiectomy is the standard surgical treatment to remove a suspicious or cancerous testicle using an incision in the inguinal canal.
- General Anesthesia at hospital or surgery center
- Home same day surgery
- Incision in the inguinal region. Identification of spermatic cord. Dissection of cord to inguinal ring and ligating the cord and dividing there to remove the testicle and cord.
- Closure with careful attention to nearby structures.
The goal is to remove all of the cancer and any involvement along the spermatic cord.
- Pain and swelling in the scrotum and groin: usually temporary and treated with analgesics and scrotal support.
- Bruising (hematoma): small bruises are common; larger hematomas may need drainage.Bleeding: intraoperative or postoperative bleeding may require additional treatment or rarely reoperation
- Infection: wound infections are uncommon but possible; treated with antibiotics and, rarely, incision drainage
- Numbness or altered sensation: numbness of the inner thigh or scrotum from nerve injury, often improves over time but may be permanent.
- Fertility Status: Sperm banking before treatment is recommended when preservation of fertility is desired.
- Hormonal: most men maintain normal testosterone levels with one testis. If testosterone falls and symptoms develop, lifelong testosterone replacement may be necessary.
- Psychologic or body-image concerns: loss of a testis can affect self-image; testicular prosthesis placement is an option but now common.
There are no alternatives to the surgical appproach. Patients with equivocal findings on ultrasound may be offered serial ultrasound imaging prior to testicle removal
Guys facing testicle cancer should have the surgery as soon as possible.