Surgery

Orchiectomy: This operation removes the entire testicle and the attached cord.

• A small incision is made where the leg meets the abdomen (the inguinal region) on the side of the testicle with the tumor.
  
  
• The testicle and attached cord are gently moved up out of the scrotum and out of the incision. Only a few stitches are needed.
  
  
• Typically, the surgery takes about an hour. It can be done with a general, spinal, or local anesthetic.
  
  
• Absorbable stitches are usually used and you can go home the same day as surgery.
  
  
• Many urologists recommend that you bank your semen prior to the surgery, because it can take months to years after therapy to return to full fertility.
  
  
• This surgery is recommended for all men with testicular cancer. It is the first and, for some men, the only treatment needed.
  
  
• This surgery should not interfere with normal erection, ejaculation, orgasm, or fertility.

Retroperitoneal lymph node dissection: This operation removes the retroperitoneal lymph nodes when they are thought to harbor cancer.

• This is a complex and lengthy surgery that requires a large incision in your abdomen (which leaves a large scar).
  
  
• Most of the abdominal organs have to be moved to get at the retroperitoneal area.
  
  
• The operation itself takes several hours and requires general anesthesia.
  
  
• You will have to stay in the hospital for at least 3-5 days, and you will have a lot of discomfort from the incision.
  
  
• Besides the usual complications of surgery and general anesthesia, this operation involves the possibility of nerve damage causing retrograde ejaculation. This means that instead of ejaculating in the usual way, the semen moves backward and ends up in the bladder. This occurs in fewer than 10% of men who have this operation.
  
  
• Another possible complication is intestinal blockage caused by scarring in the abdomen.
  
  
• More and more, chemotherapy is preferred to RPLND. The two are considered equally effective.