Orchiectomy

Orchiectomy (also named orchidectomy) is a surgical procedure in which one or both testicles are removed (bilateral orchiectomy). The surgery is typically performed as treatment for testicular cancer, in some cases of testicular torsion, and is sometimes used in the management of advanced prostate cancer.

There are three main types of orchiectomy: simple, subcapsular, and inguinal. The first two types are usually done under local or epidural anesthesia and take about 30 minutes to perform. An inguinal orchiectomy is sometimes done under general anesthesia and takes from 30 minutes to an hour to complete.

Simple orchiectomy

A simple orchiectomy is commonly performed as part of sex reassignment surgery (SRS) for transgender women, or as palliative treatment for advanced cases of prostate cancer. Orchiectomy may be required in the event of a testicular torsion as well. The patient lies flat on an operating table with the penis taped against the abdomen. The nurse will shave a small area for the incision. After anesthetic has been administered, the surgeon makes an incision in the midpoint of the scrotum and cuts through the underlying tissue. The surgeon removes the testicles and parts of the spermatic cord through the incision. 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 outward appearance of a pre-surgical scrotum.


Effects

Orchiectomy results in the immediate loss of fertility, a reduction of testosterone, and an increase in estrogen.

The side effects of a Bilateral Orchiectomy include: - infertility, loss of sexual interest, erectile dysfunction, hot flashes, breast enlargement (gynecomastia), weight gain, loss of muscle mass and osteoporosis.

The administration of Hormone Replacement Therapy (HRT) such as estrogen or testosterone after orchiectomy can help to mitigate the negative side effects.

Castration

(also known as testiclectomy) is any action, surgical, chemical, or otherwise, by which an individual loses use of the testicles: the male reproductive gland or gonad. Surgical castration is bilateral orchiectomy (excision of both testes), and chemical castration uses pharmaceutical drugs to deactivate the testes.

Castration causes sterilization (preventing the castrated person from reproducing); it also greatly reduces the production of certain hormones, such as testosterone.

The term "castration" is sometimes also used to refer to the removal of the ovaries in the female, otherwise known as an oophorectomy. Estrogen levels drop precipitously following oophorectomy, and long-term effects of the reduction of sex hormones are significant throughout the body.

The term "castration" may also be sometimes used to refer to emasculation where both the testicles and the penis are removed together.

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