Orchiectomy
What is Orchiectomy ?
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Why do you need Orchiectomy ?
Orchiectomy is indicated for:
- Testicular cancer:
- Seminoma or non-seminomatous germ cell tumors (95% of testicular cancers).
- Incidence in India: 0.5–1 per 100,000 men; more common in young men (20–40 years).
- 5-year survival: 95–98% for localized cancer (stage I); 70–80% for stage III.
- Prostate cancer :
- Advanced or metastatic cases; removes testosterone source (alternative to medical castration with LHRH agonists).
- Gender-affirming surgery:
- For transgender women; reduces testosterone and aids feminization.
- Other indications:
- Testicular torsion (if irreparable damage); severe trauma; undescended testis with cancer risk.
- Associated treatments:
- Retroperitoneal lymph node dissection (RPLND) for testicular cancer staging (if high-risk).
- Adjuvant therapy: Chemotherapy (e.g., BEP regimen) or radiation for testicular cancer; hormone therapy for prostate cancer.
- Testosterone replacement (if bilateral and not contraindicated, e.g., in prostate cancer).
- Timing:
- Performed in adults (20–40 years for testicular cancer; 60–70 for prostate cancer); urgency depends on diagnosis (e.g., immediate for suspected cancer).
The procedure aims to remove cancerous tissue, manage hormone-dependent cancers, or support gender transition, often as a straightforward surgery with minimal downtime.
Why Do Costs Vary in Philippines?
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Orchiectomy Procedure
- Before Surgery Evaluation:
- Assessment:
- Ultrasound: Confirms testicular mass (solid mass >90% likely malignant).
- Tumor markers: AFP, beta-hCG, LDH (elevated in 50–70% of testicular cancer cases).
- Imaging: CT to stage cancer (check for lymph node or distant spread).
- Blood tests: Blood sugar, clotting profile; testosterone levels (baseline).
- Preparation: Stop blood thinners (e.g., aspirin) 5–7 days prior if safe; discuss hormone replacement or fertility preservation (sperm banking).
- Consent: Risks, including infertility, are explained.
- Assessment:
- Surgical Technique:
- Orchiectomy:
- Performed under general or spinal anesthesia, lasting 30–60 minutes.
- Types:
- Radical inguinal orchiectomy: Removes testicle via inguinal incision; standard for cancer (avoids scrotal violation to prevent tumor spread).
- Simple orchiectomy: Removes testicle via scrotal incision; for benign conditions, prostate cancer, or gender-affirming surgery.
- Bilateral orchiectomy: Removes both testicles; for advanced prostate cancer or gender transition.
- Process:
- Inguinal approach (cancer): 5–7 cm incision in groin; spermatic cord clamped early to prevent tumor spread; testicle and cord removed.
- Scrotal approach (non-cancer): 3–5 cm incision in scrotum; testicle removed; scrotum closed.
- Prosthesis (optional): Silicone implant placed for cosmesis (if unilateral).
- Closure: Sutures in layers; skin closed with absorbable sutures; no drain typically needed.
- Intraoperative Tools:
- Doppler ultrasound: Confirms blood flow (if torsion suspected).
- Frozen section (rare): Confirms malignancy intra-op if diagnosis uncertain.
- Orchiectomy:
- After Surgery:
- Hospital stay: Same-day discharge or 1 day.
- Care: Ice packs to reduce swelling; wear supportive underwear; avoid heavy lifting for 2–4 weeks.
- Pain management: Mild to moderate pain for 3–5 days; managed with painkillers (e.g., paracetamol).
- Instructions: Monitor for swelling or infection; hormone replacement (if needed) starts after 2–4 weeks.
Recovery After Orchiectomy
- Hospital Stay: Same-day discharge or 1 day.
- Post-Surgery Care:
- Pain/Swelling: Mild to moderate pain for 3–5 days; swelling resolves in 1–2 weeks.
- Activity: Avoid strenuous activity for 2–4 weeks; light activities in 3–5 days.
- Incision: Sutures (if non-absorbable) removed in 7–10 days; scar fades in 3–6 months.
- Hormone effects (bilateral): Hot flashes, fatigue (if no replacement); testosterone therapy (if indicated) or estrogen (for transgender women) adjusts symptoms.
- Fertility: Unilateral preserves fertility (50% chance); bilateral causes infertility (sperm banking advised pre-op).
- Follow-Up:
- Visits at 1 week (check healing), 1 month, and every 3 months for 2 years (cancer recurrence risk).
- Imaging: CT at 3–6 months for testicular cancer surveillance; tumor markers monitored.
Most resume normal activities in 1–2 weeks; full recovery takes 4–6 weeks. Success rate: 5-year survival for localized testicular cancer is 95–98%; 70–80% for stage III with adjuvant therapy.
Risks and Complications
- Surgical Risks:
- Bleeding (1–3%): Hematoma in scrotum or groin; may resolve or need drainage.
- Infection (1–3%): At incision site; treated with antibiotics.
- Anesthesia risks (<1%): Reaction to anesthesia; rare in healthy patients.
- Post-Surgery:
- Swelling (5–10%): Scrotal edema; resolves with ice and elevation.
- Chronic pain (1–2%): At incision site; usually temporary, managed with painkillers.
- Hormone imbalance (bilateral, 100%): Low testosterone; causes fatigue, low libido; managed with replacement therapy.
- Prosthesis issues (1–2%, if placed): Infection or displacement; may need removal.
- Long-Term:
- Recurrence (5–10%, testicular cancer): Cancer return (retroperitoneal nodes, lungs); needs regular follow-up.
- Psychological impact (5–10%): Body image concerns; counseling or prosthesis helps.
Report fever, severe swelling, heavy bleeding, or persistent pain promptly.
Frequently Asked Questions (FAQs)
What causes the need for orchiectomy?
Testicular cancer, advanced prostate cancer, gender-affirming surgery, or severe testicular damage (e.g., torsion, trauma).
Can I avoid orchiectomy?
Yes, if low-risk cancer: Surveillance for stage I testicular cancer; medical castration for prostate cancer; surgery needed for confirmed malignancy or transition.
Is orchiectomy painful?
Mild to moderate pain for 3–5 days, managed with medication; resolves in 1–2 weeks.
How soon can I resume normal activities?
Light activities: 3–5 days; full recovery: 4–6 weeks; avoid strenuous activity for 2–4 weeks.
Is orchiectomy covered by insurance in India?
Often covered (medical necessity); confirm with your provider; Ayushman Bharat often subsidizes; coverage for gender-affirming surgery varies.
Signs of complications?
Fever, severe swelling, heavy bleeding, or persistent pain.
Will I need hormone replacement?
Yes, if bilateral: Testosterone (for men, if not contraindicated) or estrogen (for transgender women); unilateral usually preserves testosterone production.
Lifestyle changes post-surgery?
Monitor hormone levels, attend follow-ups (cancer surveillance), consider counseling for body image, and avoid trauma to surgical site.
Conclusion
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Looking for Best Hospitals for Orchiectomy
Note: we are not promoting any hospitals
We do not promote any hospitals. All details are sourced from Google and hospital websites. Please verify independently. Start with your surgery—here’s the list of government, budget, and superspecialty hospitals accredited by the Department of Health (DOH), Philippine Health Insurance Corporation (PhilHealth), and Joint Commission International (JCI)
- click on your city and schedule your surgery now done in good hands.
| City | Minimum Price (₱) | Maximum Price (₱) |
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Angeles City |
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Antipolo |
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Bacolod |
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Bacoor |
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Baguio |
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Butuan |
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Cagayan de Oro |
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Caloocan |
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Cebu City |
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Dasmariñas |
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Davao City |
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General Santos |
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General Trias |
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Iligan |
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Iloilo City |
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Las Piñas |
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Makati |
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Malolos |
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Manila |
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Muntinlupa |
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Parañaque |
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Pasay |
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Pasig |
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Puerto Princesa |
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Quezon City |
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San Fernando |
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San Jose del Monte |
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Taguig |
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Valenzuela |
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Zamboanga City |
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Disclaimer
This information is sourced from open platforms and is for general awareness only. Costs may vary based on individual cases. Please consult a qualified doctor for medical advice and explore options within your budget before deciding on the procedure.