Removing a testicle (orchidectomy) for testicular cancer

Surgery to remove a testicle is called a radical orchidectomy or orchiectomy. You usually have this surgery if tests show that it's likely you have testicular cancer.

You can usually go home later on the day of your surgery but you might need to stay in hospital overnight.

Why you might have this surgery

You need to have this surgery to:

• make a definite diagnosis of testicular cancer
• find out what type of testicular cancer you have

This surgery also removes the cancer and is one of the main treatments for testicular cancer. After surgery, your doctor and a team of experts will discuss the best treatment plan for you. You may not need any more treatment. If you do have further treatment this may be: 

• chemotherapy
• radiotherapy
• further surgery

Your treatment depends on:

• the stage of the cancer

• the type of cancer (seminoma or non seminoma)

• the risk of the cancer coming back

What happens

You have the operation under either:

• a general anaesthetic  or
• a spinal anaesthetic (where you are awake but can't feel anything from the waist down)

The surgeon makes a cut in the groin and cuts the spermatic cord to remove the testicle. They might also remove nearby lymph nodes.

The surgeon sends the removed testicle to the laboratory for examination under a microscope. It takes a few days to get the results.

Removing both testicles

It isn't common to have testicular cancer in both testicles. If you do have cancer in both testicles you would need surgery to remove them both.

Having a false testicle (prosthesis)

Your surgeon can usually put a false testicle in place of the one removed. This is called a prosthesis or an implant. They will discuss this with you before the operation. They will do their best to match the testicles, but sometimes the prostheses may look slightly different. 

Your surgeon can tell you more about this and help you decide what you want to do. They can usually fit a prosthesis at a later date if you would rather wait. 

After the surgery

You can usually go home later that day but might need to stay in hospital overnight.

You have stitches that are dissolvable. These can take about 3 to 4 weeks to dissolve. And you usually have a dressing over the wound. Your nurse will explain how to look after the wound before you go home. They will tell you when to remove the dressing and when you can shower. 

Your groin and scrotum may be uncomfortable for a week or so. You might need to take mild painkillers. 

Most people can go back to normal activities, including work, after 2 weeks. But this depends on the type of work you do. You should avoid heavy lifting and strenuous exercise for a few weeks.

Speak to your doctor or specialist nurse about starting normal sexual activity again. This is usually when your wound is healed and you feel comfortable.

Possible risks

There is a risk of problems or complications after any operation. Most are minor but some can be more serious. 

Pain and discomfort

You usually have some pain, discomfort and bruising for the first week or so. But it is possible to control your pain. There are different painkillers you can have. Speak to your nurse about what you can take when you are at home.

Contact your specialist nurse or hospital advice line if you still have pain or if it gets worse.

Bleeding around the wound 

Your nurse will let you know what to do and who to contact if you have bleeding around the wound site.

Risk of an infection 

There is a risk of developing an infection around the wound site. Sometimes the prosthesis may need to be removed if this happens.

Symptoms of an infection include:

• feeling generally unwell – not able to get out of bed
• a change in your temperature – 37.5°C or higher or below 36°C
• flu-like symptoms – feeling cold and shivery, headaches, and aching muscles
• a throbbing, painful wound
• pain having a wee, going more often or cloudy or foul-smelling wee
• skin changes – redness, feeling hot, swelling or pain

Sex and fertility

Surgery to remove one testicle shouldn’t affect your ability to get an erection.

For most men this surgery won’t affect your ability to have children. But sometimes, the remaining testicle might not work so well. This could reduce your fertility.

Talk to your doctor if having children is important. They usually suggest sperm banking before having surgery.

Removing both testicles

If you did have cancer in both testicles you would need surgery to remove them both. This isn't common. After this surgery you have testosterone replacement therapy. 

Possible changes to your sex drive can be difficult to come to terms with. Talking to someone about this could help. This could be a close friend or a professional.

If you have testicular cancer

Your doctor will give you an appointment to get the results of the operation. They will tell you whether the operation shows you have cancer. And what type of testicular cancer you have.

You may need further tests and treatment if you have testicular cancer.

You have regular monitoring with appointments and tests if:

• the surgery removed all the cancer
• there is a low risk of it coming back.

You might have treatment with chemotherapy, radiotherapy or further surgery if there is a higher risk of the cancer coming back.