Testicle removal, known medically as an orchiectomy, is a surgical procedure to remove one or both testicles. This operation is most commonly performed to treat or prevent testicular cancer, but it can also be necessary due to trauma, infection, or as part of gender-affirming care. Understanding the process and what to expect during recovery and beyond can help individuals prepare and cope with the changes.
Immediate Post-Operative Recovery
After an orchiectomy, managing discomfort is a primary concern. Patients can expect pain, tenderness, or soreness at the incision site, which is typically managed with over-the-counter pain relievers like acetaminophen or NSAIDs. Applying ice packs to the area for the first day or two, in 20-minute intervals, can also help reduce swelling and discomfort.
Swelling and bruising around the scrotum and incision are common and usually subside within two to four weeks. Incision care involves keeping the area clean and dry; showering is generally permitted 24 to 48 hours after surgery. Gently wash the incision with soap and water, followed by careful patting dry. Patients should avoid baths or swimming for several weeks until the incision fully heals to prevent infection.
Activity restrictions are important for proper healing. Patients are advised to avoid strenuous activities like heavy lifting, running, or intense exercise for two to three weeks. Driving may be restricted for one to two weeks, especially if narcotic pain medication is used. Most individuals can return to light daily activities and work or school within two to three weeks, but it is important to listen to the body and avoid anything that causes strain.
Physical and Hormonal Changes
The removal of one or both testicles can lead to various physical and hormonal adjustments. If only one testicle is removed, the remaining healthy testicle often compensates, maintaining normal testosterone levels and fertility. However, if both testicles are removed (bilateral orchiectomy), the body’s testosterone production will significantly decrease, often to minimal levels, necessitating testosterone replacement therapy (TRT).
Low testosterone can manifest through several symptoms, including fatigue, mood changes, reduced libido, and difficulty achieving erections. Other potential effects include hot flashes, decreased muscle mass, and concerns about bone density, which can be mitigated with TRT. Testosterone levels are typically checked through blood tests, usually in the morning when levels are highest.
Fertility considerations depend on the extent of the surgery. Removal of both testicles results in infertility because the body can no longer produce sperm. For individuals who may wish to have biological children in the future, sperm banking before the procedure is an option to preserve fertility.
Changes in appearance and body image are also common. The scrotum will appear empty after the removal of a testicle. To address this, some individuals opt for testicular prosthetics, which are silicone implants filled with saline or silicone gel designed to mimic the feel, shape, and weight of a natural testicle. These prosthetics are for cosmetic purposes and do not produce hormones or sperm.
Emotional and Psychological Well-being
Undergoing testicle removal can have a significant emotional and psychological impact. It is common to experience a range of feelings, including grief, anxiety, and depression. Concerns about body image, self-esteem, and masculinity can arise as physical changes become apparent. These feelings are a normal part of the adjustment process.
Coping strategies involve open communication with partners and engaging with support networks. Discussing feelings with loved ones provides reassurance and strengthens relationships. Support groups, online or in person, offer a space to connect with others who have undergone similar experiences, fostering a sense of understanding and community.
Seeking professional help is also an important step if emotional distress becomes overwhelming or persistent. Mental health professionals, such as counselors or therapists, can provide strategies and support to navigate these feelings. Addressing psychological impacts proactively contributes to well-being and adaptation after surgery.
Ongoing Care and Support
Long-term well-being after testicle removal necessitates continued medical oversight. Regular follow-up appointments with healthcare providers, including specialists like urologists, endocrinologists, and oncologists (if cancer-related), are important. These visits ensure proper healing, monitor hormone levels, and address any emerging concerns.
For those who underwent orchiectomy for cancer, ongoing monitoring for recurrence is a key aspect of care. This may involve regular imaging and blood tests to detect any signs of disease return. Management of long-term side effects, particularly adjustments to hormone replacement therapy, is also handled during these follow-up appointments to ensure optimal health and quality of life.
Beyond medical appointments, various resources offer continued support. Patient advocacy groups provide valuable information and connect individuals with shared experiences. Online communities can be a convenient way to find peer support and practical advice. Additionally, mental health professionals remain available to assist with any ongoing emotional or psychological adjustments, reinforcing the importance of a comprehensive support system.