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.