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Testicular Cancer Surgery: What to Expect
If you have been diagnosed with testicular cancer you will need to have a surgical procedure called an orchidectomy. This procedure removes the affected testicle and the tumour. This blog will let you know what to expect on the day of your surgery, as well as what will be involved in your aftercare and recovery.
An orchidectomy will confirm:
- the diagnosis of testicular cancer
- the type and stage of testicular cancer
Surgery by itself can cure testicular cancer for some men, meaning no further treatment is required. For others, further treatment such as chemotherapy or radiotherapy may be required, if the cancer has spread to other areas of the body.
What happens during an orchidectomy?
You will usually have the operation under a general anaesthetic, which means you are asleep throughout the procedure. However, sometimes a spinal anaesthetic may be used, which means you are awake but will not feel anything from the waist below.
The operation typically takes between 30 minutes and 1 hour. For the surgeon, this is a relatively simple procedure in comparison to many others.
The surgeon will:
- make an incision in the lower abdomen area
- cut the spermatic cord
- take out the affected testicle
In some very rase cases where men have extremely small tumours, the surgeon may remove just a part of the testicle. This is called a partial orchidectomy, but again this is extremely rare.
The removed testicle will be sent to a laboratory for examination under a microscope. This usually takes a few days to get results.
Possible risks
The usual risks of any surgical procedure and using anaesthetic apply, such as having a reaction or getting an infection. There are some minor risks post-operation that may apply:
Pain and discomfort:This is pretty standard after any surgery. You can expect to have some soreness and bruising around the cut/stitched area for a couple of weeks after your operation.
Sex and fertility: Having a testicle removed will not affect your ability to get an erection and for most men it will not affect your ability to have children. In some rare cases, the remaining testicle might not work so well, which can reduce your fertility. If having kids is important to you, your doctor or urologist may suggest sperm banking before having surgery.
Removing both testicles: If you have cancer in both testicles then both will need to be removed. This isn’t common, but in order to maintain your sex drive and have the ability to get an erection you will need testosterone replacement treatment.
Arriving at the hospital
Before getting to the hospital on the day of your surgery you will typically be given a set of instructions.
These may include:
- Eat a light breakfast 4 or 5 hours before your surgery.
- No food or liquids that aren’t plain water after this time.
- Still, plain water is fine up until 1 to 2 hours before your surgery.
- At a precise time (usually an hour or so before your surgery) you are asked to drink 250ml of still, plain water.
- No chewing gum.
- No smoking 48 hours before surgery.
- No drinking alcohol 48 hours before surgery.
The option of a prosthetic testicle
Before your surgery you will have the opportunity to meet your surgeon, who will explain the procedure and do an initial examination of you before continuing. At this point you will also be given the option of having a prosthetic testicle replacement. This is an artificial (human-made) testicle that replaces the one lost due to testicular cancer.
A prosthetic testicle doesn’t produce sperm of testosterone, but it has a similar shape, weight and feel to a human testicle. Many men choose to have one of these to mimic the appearance and feel of a testicle, improving self-confidence and calming and psychological fears.
Read our blog on the ‘The Nuts and Bolts of Prosthetic Testicles’for more information.
Going to sleep and waking up
We’re not meaning to be blase or facetious about it, but this is essentially true. The surgeon and the anaesthetist will talk you through what is about to happen and get you prepared for it. But then after that, your experience of the surgery will be going to sleep and waking up again – typically within about 2 or 3 hours’ time. It is literally over in a flash.
This is of course, unless you have a spinal anaesthetic, in which case you will be awake for the procedure – and therefore it will seem definitely longer for you.
If you have a general anaesthetic, you will feel a tiny scratch on the back of your hand as they put an oxygen mask over your face. You’ll drift off within a matter of seconds. The next thing you will know, you will wake up in another room (outpatient/recovery room) feeling rather groggy, and perhaps a little sickly. This is a hangover from the surgery and anaesthetic, which is normal.
At first you may have a cold burning sensation around your testicles, and the area around your wound/scar will be extremely sensitive and perhaps a little swollen. This is all normal and shouldn’t last more than a few days.
Leaving the hospital
Once you have fully woken up, a nurse will usually offer you some water, a piece of toast and some pain relief. They will let you know how the surgery went and make sure you are feeling okay. Typically, at this point, you may be told that if you can eat the piece of toast and pass water (pee) then you can go home within the hour. You must have someone come pick you up though, or have someone that can take you home.
It is as quick as that. You can be in and out, and back home, within 4 to 5 hours if everything goes as planned. You are not usually given any medication to take with you, but are advised to stock up on paracetamol and ibuprofen. Despite the quickness of this procedure, it is still a major operation and therefore it is important you rest up and do as little as possible for a few weeks as your body heals.
Aftercare and recovery
You should start to feel normal again in around 3 to 5 days’ time, but you should not be fooled into this false sense of security. The risk of infection or bleeding in the scrotum continues past this, and if you do not take it easy you increase the risk significantly.
You may be told to avoid:
- any exercise at all for 3 to 5 weeks
- lifting anything or housework for at least 1 week
- removing the bandaging for at least 5 days
- showering for at least 5 days
- rubbing or soaping the affected areas for at least 5 days
- having sex until you are fully recovered
The results of your histology report on the tumour should be with you within 1 week of your surgery.
Reach out and get support
Changes to your physical appearance, as well as potential changes to your sex drive and becoming infertile (as rare as that may be), can be difficult to come to terms with. Talking to someone about this can really help, especially those that have been through this before themselves.
If you are currently going through a testicular cancer diagnosis, are waiting for surgery, or are a survivor and would like some support – please email support@baggytrousersuk.org.
