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An orchidectomy or orchiectomy refers to removal of one or both testicles in males. Either term means the same thing, yet orchidectomy tends to be the more common name for the procedure in the UK. There are several reasons why this surgery could be required. Testicular cancer is clear indication for orchiectomy, and some men may have unilateral or bilateral orchidectomy as a means of reducing testosterone that can exacerbate prostate cancer in advanced stages. Additional reasons why testicle removal might be required include grave traumatic injury to a testicle or personal preference for those undergoing gender reassignment therapy.
It would be fair to state that except in gender reassignment therapy, most men do not willingly undergo orchidectomy. It is comparable in producing anxiety to the way many women might feel who must have oophorectomy (ovary removal) or hysterectomy (uterine removal). Especially if both testicles are removed, rate of fertility drops to nil, and men interested in having children should talk to their doctors about banking sperm before the procedure. Decline in testosterone may have minor to major effects on sexual interest, and these may not always be easily remedied. Low testosterone is often treated with testosterone supplementation, but if the reason for orchiectomy is to reduce testosterone levels, this treatment option may not be open.
However, men should note that removal of a single testicle might not be dramatic in its aftereffects. Fertility is still possible and the remaining testicle continues to produce testosterone and sperm. Many men continue to be virile, interested in sex and as masculine as ever. One need only look at public examples of people who have undergone orchidectomy, like athlete Lance Armstrong, to be assured that removal of a testicle may have little to do with masculinity, physical strength or virility.
Conversation with doctors prior to an orchidectomy is always valuable. Doctors may tell patients exactly how they plan to perform this surgery, which can vary. Incisions may occur in the scrotum or the groin, and all or part of the testicular gland could be removed. When testicular cancer is present, the most common procedure is an inguinal or radical orchidectomy, which accesses the testicles through the groin and removes a greater amount of spermatic cord and testicle tissue. The purpose of this is to make certain all cancerous tissue is removed as needed.
No surgeries are without risk, and in addition to some sexual function issues, men who undergo orchidectomy may experience symptoms that include mood changes, weight gain, slight enlargement of breast tissue, or a sense of fatigue. Again, some of the symptoms could be treated with hormones if this doesn’t interfere with cancer treatment. Men who have had radical orchiectomy for testicular cancer need to continue to get screening, since there is some risk of cancer recurrence. Those with prostate cancer need careful follow-up with doctors too.