Cancer of the Testicle (cont.)
Testicular Cancer Surgery (Without Medical Treatment)
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 20-40 minutes. It can be done with a general, spinal, or local anesthetic.
- Absorbable stitches are usually used, and the patient can go home the same day as surgery.
- Many urologists recommend that men bank their 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 single large incision or several small incisions in the abdomen.
- 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.
- Patients will stay in the hospital for about three to five days.
- 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 manner, the semen moves backward and ends up in the bladder. This occurs in fewer than 5% of men who have this operation. If there is a large lymph node in the retroperitoneum, rates of retrograde ejaculation increase.
- Another possible complication is intestinal blockage caused by scarring in the abdomen.
Steven C Campbell, MD, PhD
Scott H Plantz, MD, FAAEM
Francisco Talavera, PharmD, PhD
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