If
your doctor tells you that you need an orchiectomy, dont freak
out. It may cause you some issues, but in most physical instances, the
orchiectomy should not affect you in any way other than minor post
operative recovery. One testicle is all that is needed to do all the
things that you have always done. You will be able to return to your
normal sex life soon after recovery from the orchiectomy - a minor
surgery. Yes it is minor, infact an orchiectomy is almost always done
in an outpatient facility, which means you wouldnt even need to stay in
a hospital for a night. Most men can even father children after an
orchiectomy with only one testicle - ask your doctor about possibly
banking sperm, prior to the orchiectomy just as a precaution.
Bi-Lateral
Orchiectomy, which means they remove BOTH testicles due to cancer or
fear of cancer, is also nothing that will change your normal routine of
life. Natrually, you will not be able to father children with no
testicles - so you will definately want to bank sperm if you are
planning on ever having children of your own. Medical advances has made
it easy to "replace" testosterone levels in your body and maintain a
normal, happy sex life! Talk to your Doctor about different hormone
replacement options. Currently there are daily gel applications and
shots available. To learn more about "Sex and Testicular Cancer", Click Here.
Before the Orchiectomy...
The
doctor should have some blood tests done. They need to check your blood
for the presence of certain tumor markers
and their levels while the tumor is still in your body. These tumor
markers can later be used to determine if the cancer has spread outside
of the testicle, but it is very important that they begin testing and
establish some baselines before the surgery. Similarly, we strongly
encourage newly diagnosed men to ask their doctors to check their serum
testosterone level before the orchiectomy. There is no therapeutic
reason to do this, but we have found that it may be useful to know this
number at some point in the future. The doctors may also give you the
option of an epidural or general anesthesia for the orchiectomy.
General anesthesia is clearly the more traditional choice. However, an
epidural (lower back) block may be beneficial if you do not react well
to general anesthetics. With the epidural anesthetic it is possible
(though maybe not desirable!) to remain awake and talkative during the
whole operation! Both anesthetics have possible problems and side
effects, carefully discuss your options with your doctor.
The Orchiectomy...
The
actual removal is done by making about a 4 inch incision along the
"bikini line" through the lower abdomen on the side in question--they
will NOT cut through the scrotal sack whatsoever during an orchiectomy.
Once the incision has been made, the surgeon pushes the testicle up
through the pelvic region and out it comes. A snip here, a stitch
there, and you're done before you know it. Average time on the table is
about 45 minutes to an hour, but you should probably expect to stay in
the hospital at least overnight following the orchiectomy. Unlike the
RPLND, this operation is very simple and should not require any special
expertise on the part of the surgeon.
After
the orchiectomy - surgery, they will probably wake you up pretty soon
after and encourage you to get up and try to walk. It will hurt, but it
will also get your insides working faster and get you out of the
hospital sooner. You'll probably have a reasonable amount of pain at
the incision, and you might want to consider wearing sweatpants for a
week or two. There may also be numbness of the skin around the
incision, but that should eventually go away. Different people will
react differently to the operation. Some will be up and about the next
day; others will lay around in bed for a while. We recommend that you
try to get up and do something because otherwise you may just end up
sitting around feeling sorry for yourself. Your attitude will make a
huge difference in your recovery time; the better it is the better you
will do. We suggest you learn about the cancer, so that you know what
to expect from the pathology report and from the doctor and the future
ahead -- but don't let it overwhelm you. The doctor probably wont let
you drive or do any heavy lifting for a couple of weeks, so be prepared
to ask for help getting around. What is recommended post-surgery? Click Here to
learn about different follow-up care plans.
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