An orchiectomy is a surgical procedure involving the removal of one or both testicles. This can prompt various physiological and psychological adjustments. Understanding the potential impacts on hormonal balance, fertility, emotional well-being, physical appearance, and sexual health is important for those undergoing the procedure.
Hormonal Balance After Removal
The testicles are the primary source of testosterone, a hormone influencing male characteristics like muscle mass, bone density, and sex drive. When one testicle is removed, the remaining testicle often compensates by increasing its hormone production to maintain adequate levels. This means many men who undergo unilateral orchiectomy do not require testosterone replacement therapy.
However, in some cases, the remaining testicle may not fully compensate, leading to a decrease in testosterone. Symptoms of low testosterone can include fatigue, mood changes, reduced muscle mass, increased body fat, decreased bone density, hot flashes, and reduced sex drive. If low testosterone occurs, hormone replacement therapy can help manage these symptoms and improve overall well-being.
Impact on Fertility Potential
A common concern following orchiectomy is its effect on fertility. One healthy testicle is generally sufficient for sperm production and maintaining fertility, often increasing its production to compensate. Studies indicate that paternity rates after unilateral orchiectomy can be favorable, approaching 90% in individuals with a normal contralateral testicle.
However, certain factors can influence fertility outcomes. Pre-existing conditions, such as a low sperm count before surgery, or the reason for the orchiectomy (e.g., cancer treatment affecting the remaining testicle) can impact fertility. For individuals concerned about future fertility, options like sperm banking before the procedure can be considered.
Psychological and Emotional Well-being
The removal of a testicle can have significant psychological and emotional effects. Body image concerns are common, with some men reporting feelings that their body has changed. This can lead to anxiety, depression, and a sense of loss or altered masculinity, which can affect self-esteem and confidence.
Seeking support from healthcare professionals, such as therapists or counselors, or connecting with support groups can provide beneficial coping strategies. Open communication with partners and loved ones can also help in navigating these emotional adjustments.
Physical Changes and Sensations
Following the removal of a testicle, visible physical changes occur in the scrotum. It may appear empty or have scarring from the surgical incision. For cosmetic reasons, some individuals choose to have a testicular prosthetic implanted. These implants, typically made of silicone or saline, mimic the appearance and feel of a natural testicle but do not function like one.
Some individuals may experience phantom sensations or discomfort in the surgical area, similar to phantom limb sensations. These sensations can include pain or non-painful feelings, and while they often resolve within months, they can persist for some. The remaining testicle may also undergo compensatory hypertrophy, growing slightly larger as it works to increase hormone and sperm production.
Sexual Health and Drive
Sexual health and libido can be influenced by orchiectomy, with both physiological and psychological factors playing a role. While the remaining testicle often compensates, a decrease in testosterone can lead to reduced libido. Some individuals may experience a temporary or persistent reduction in sexual desire.
Erectile function can also be affected, though low testosterone is not the sole cause of erectile difficulties. Other health conditions, psychological factors like body image concerns, and confidence can also play a part. If sexual health concerns arise, discussing them with a healthcare provider can help identify the underlying cause and explore potential treatments, including hormone replacement therapy if low testosterone is a contributing factor.