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Orchiectomy, also known as an orchidectomy, or simply orchi, is a surgical procedure in which one or both testicles are removed. When just one testicle is removed, it is called unilateral simple orchiectomy. When both testicles are removed, the procedure is called bilateral orchiectomy. The surgery is typically performed as a treatment for testicular cancer. Some other cases where simple orchiectomy is performed are:
As the name implies, simple orchiectomy is a simple procedure, taking about just 30 minutes to be performed.
Every procedure requires the patient to stay in a certain position. For a simple orchiectomy, the patient is made to lie in a flat or in medical terms, a supine position on an operating table. The patient is prepped and draped in the usual standard sterile manner. The penis is taped against the abdomen so that the scrotum is exposed. The nurse will shave a small area to prepare the region for an incision.
It is a simple procedure that takes only 30 minutes to be performed. It is done under local or regional anesthesia or epidural anesthesia. An example of a commonly used local anesthetic (LA) is the lidocaine. Epidural anesthesia is given by injecting a needle into a small area of the back so that anesthetic can be injected into the epidural space.
After the anesthetic has been administered, the surgeon makes an incision in the midpoint of the scrotum and cuts through the underlying tissue, going through the skin, subcutaneous tissue, dartos layer, and the tunica vaginalis.
The surgeon removes the testicles, along with all the gubernacular attachments, and parts of the spermatic cord through the incision. All the bleeders are coagulated. The incision is closed with two layers of sutures and covered with a surgical dressing.
If the patient desires, a prosthetic testicle can be inserted before the incision is closed to present an aesthetic outward appearance of a pre-surgical scrotum.
Simple orchiectomy can be performed as an outpatient procedure. The typical length of time for this procedure is usually about 30 minutes. Nonetheless, you always have the option to stay a little longer at the hospital for your recovery if you choose.
It is also important that you have regular check-ups with your surgeon while you’re still in recovery. In most cases, the doctor will use stitches that dissolve on their own in about 1 to 3 weeks and do not need to be removed.
The usual recovery time can take about a month. The first two weeks can be especially painful and patients are advised to not engage in vigorous exercise or effort. The Doctor will prescribe pain medications (NSAIDS) to ease your discomfort. It is very advisable that you take 2 weeks off work after the operation to fully help the recovery.
Simple orchiectomy has a high success rate where most patients leave the operating room happy with the procedure.
Following bilateral simple orchiectomy, there can be depletion in androgen levels, a relative increase in estrogen levels, metabolic changes, and other numerous consequences, including:
Alternatives to a simple orchiectomy are observation and certain drugs, like LHRH analogs, anti-androgens, steroid anti-androgens, estrogens. Other more advanced hormonal therapy regimens and experimental chemotherapy have been reserved for later stages of cancers.