Overview

Surgery to remove a testicle is called a radical orchidectomy.  During a radical orchidectomy, we remove your testicle and the spermatic cord attached to it. The spermatic cord is a bundle of tissue that runs from your abdominal area (tummy) to your testicles.

Your doctor has recommended a radical orchidectomy for you because there’s a lump in your testicles that could be cancerous.

Testicular cancer is rare, but it’s the most common type of cancer in young men. About 1 in 100 cancers in men are testicular cancer. Treatment for it is usually very effective, especially when we treat it early.

The best way to diagnose and treat testicular cancer is by having a radical orchidectomy to remove the testicle with the lump.

If the lump is small, we might consider only removing a part of your testicle. This is called a partial orchidectomy.

Diagnosing testicular cancer

A radical orchidectomy is the only way to confirm if the lump in your testicles is cancerous or not.

It allows us to carefully examine the testicle and take a tissue sample for testing. A specialist doctor (pathologist) will examine the tissue with a microscope to check if it’s cancerous or non-cancerous (benign).

If it’s cancerous, the pathologist can diagnose the type, grade and stage of the cancer.

You’ll do other tests before and after having a radical orchidectomy to get more information about the lump in your testicles.

Ultrasound scan

The first test you’ll usually have is an ultrasound scan. This is a simple procedure that lets us see images of the lump in your testicles.

Blood test

Some substances in your blood increase when you have testicular cancer. These are called tumour markers. They can help identify what type of cancer you have.

Tumour markers include:

• alpha-fetoprotein (AFP)
• beta human chorionic gonadotrophin (bHCG)
• lactate dehyrdrogenase (LDH)

You’ll have a blood test before and after a radical orchidectomy to check for tumour markers.

CT scan

We use a CT scan to check your chest, abdomen (tummy) and pelvis. This scan shows us a detailed, 3D image of the inside of your body.

You’ll have a CT scan before and after a radical orchidectomy to check if there’s cancer in other parts of your body.

Benefits of a radical orchidectomy

A radical orchidectomy is the best way to diagnose and treat testicular cancer.

If the lump in your testicle is cancerous, removing the testicle can also remove the cancer. This is sometimes the only treatment you need to cure the cancer.

We usually do a radical orchidectomy within 2 weeks after your ultrasound scan. This can feel rushed and unexpected, but it’s important to remove the testicle as soon as possible to prevent the cancer from growing.

Risks of a radical orchidectomy

Like all operations, a radical orchidectomy has some risks. We’ll discuss all the risks with you so you know what to expect. Talk to us about anything you’re worried about.

General risks of surgery include:

• complications with having a general anaesthetic
• blood clots in a vein (deep vein thrombosis)
• blood clots in the lung (pulmonary embolism)
• stroke
• heart attack

Some risks are more serious, but these are rare:

• less than 2 in 100 people have bleeding after surgery
• less than 1 in 100 people get an infection
• 5 in 100 people get temporary swelling of their scrotum (the bag of skin containing your testicles)

Sex and fertility

Removing a testicle does not stop you from having sex. You can still get erections as normal.

It’s also still possible for you and your partner to get pregnant (conceive). Your other testicle will take over the role of the one that was removed.

If you and your partner are planning to get pregnant in the future, you can have an appointment with the assisted conception unit. They’ll check your sperm levels before your surgery.

If your sperm levels are low, you can freeze your sperm to increase your chances of conceiving a baby in the future.

If we cannot find any sperm in your semen, you might be able to have an onco-TESE procedure to collect sperm from your testicles surgically.

Changes to how your scrotum looks

Your scrotum will look different after having a radical orchidectomy.

If you’re concerned about this, we can insert an artificial testicle to make the scrotum look more even. Talk to your doctor if you’re interested in this.

Giving your permission (consent)

We want to involve you in decisions about your care and treatment. If you decide to have the procedure or treatment, we’ll ask you to sign a consent form. This says that you understand what’s involved and agree to have the treatment.

Read more about our consent process.