What Is an Orchidectomy?

Testicular tumors undergo testicular resection. The spermatic cord is ligated and cut off at a high position near the inner ring, and then tumor testicular resection is performed. When testicular resection is performed due to other lesions or injuries, the spermatic cord can be severed and the testis removed.

Basic Information

Chinese name: Orchiectomy

Visiting department: Urology

Orchid anesthesia and preoperative preparation

Anesthesia mode

Spinal anesthesia or continuous epidural block anesthesia; general anesthesia or basic anesthesia plus local anesthesia for children.

2. Preoperative preparation

(1) For epididymal testicular tuberculosis, anti-diarrheal treatment should be performed for more than 1 week before surgery; if it is purulent epididymal testicularitis, anti-infective treatment should also be performed before surgery.

(2) Shave pubic hair one day before surgery.

Indications for orchiectomy

1. Testicular tumor or other malignant tumors in the scrotum.

2. Adults with high cryptorchidism and testicular atrophy, or unable to descend and fix in the scrotum.

3. Severe testicular injury, who can not be retained after surgical exploration.

4. The spermatic cord is twisted causing the testis to have necrosis.

5. Advanced epididymal testicular tuberculosis, resulting in testicular failure to retain.

6. Suppurative epididymis orchitis, repeated attacks, resulting in testicular tissue necrosis.

7. Testicular sheath with old hematoma, causing testicular atrophy.

8. Other diseases need castration treatment, such as prostate cancer, bilateral testicular resection, a small part of benign prostatic hyperplasia, and even bilateral testicular resection can also be performed.

Orchiectomy surgery steps

1. Patients who have been diagnosed with a testicular tumor before surgery should use an oblique inguinal incision; non-testicular tumor patients should use an external upper scrotal incision; bilateral non-tumor testicular resection can also use a scrotal median incision. If the nature of the testicular lesion is not clear before the diagnosis, a high scrotal incision can be used.

2. Isolate the spermatic cord until near the inner groin ring.

3. Finally remove all scrotal contents such as testis, epididymis and spermatic cord. If the tumor adheres to the surrounding tissue, this part of the scrotum should be removed together.

4. Drainage and suture.

Complications after orchiectomy

Bleeding, infection, lymphatic fistula, deep vein thrombosis.

Nursing after orchiectomy

Observe the wound for bleeding, exudate, keep the surgical site clean and smooth and fix the various channels, pain care, the first day after surgery, semi-recumbent position, bedside activities, the second day, the patient's condition is stable to guide patients out of bed .

Orchiectomy considerations

1. Hold the scrotum or pressurize to prevent bleeding or hematoma formation in the scrotum.

2. Drainage in the scrotum was removed 24 to 48 hours after surgery.

3. The wound suture was removed 7 days after the operation.

4. After the testicular malignant tumor is removed, perform retroperitoneal lymphadenectomy or radiotherapy or chemical treatment according to the pathological nature and systemic conditions.