Testicular Cancer

Orchidectomy (testicle removal)

When cancer is suspected the best way to confirm the diagnosis is to remove the entire testicle, an operation called an orchidectomy. This is almost always done under general anaesthetic, though can be also be done with an epidural injection. The testicle is removed through an incision in the groin, and then the cells are examined under the microscope. Subsequent treatment will depend on the type of tumour and whether or not it has spread.

Explains that he did not want to go to sleep for the operation so had an epidural anaesthetic.

Explains that he did not want to go to sleep for the operation so had an epidural anaesthetic.

Age at interview: 39
Sex: Male
Age at diagnosis: 36
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Well the day I got into the hospital they had to shave me and all this. The wife was there with me all the time, but I have this fear of being put to sleep so I actually stayed awake through the whole operation. You know and I was laughing and joking about with the doctors, I didn't feel a thing. I mean they just said you know "It's gone, off you go." And that was it.

You had an epidural?

Yeah I had an epidural, which I couldn't actually walk with because it makes your legs go like all jelly, you're all numb down below. And I wanted to go outside and they said "You can go outside when you can stand up," but I couldn't stand up, they was pushing me around in the wheelchair. But as I say I have this fear of being put to sleep and so I wouldn't have it. I mean I said "If you want to take it out you can but I will have to stay awake because I", you know so that was it. I stayed awake and I still had to go to a recovery room for an hour after the operation. And I mean the operation I think took altogether about 40 minutes. It didn't take that long at all which surprised me.
 
Some men we spoke to were not clearly informed that they would almost certainly lose the entire testicle. Some were admitted to hospital expecting just to have a biopsy or to have the lump removed. This misconception left these men and their families feeling angry and distressed (see 'Talking to doctors').

Recalls that he expected only to have the lump removed and was shocked to discover he was having an orchidectomy.

Recalls that he expected only to have the lump removed and was shocked to discover he was having an orchidectomy.

Age at interview: 21
Sex: Male
Age at diagnosis: 21
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The doctor came round, marked on my left thigh what testicle it was you know that they were going to be operating on. Then a consultant came in, he said that did I know what the operation entailed? I said, "Yes removing the lump." He said, "A radical orchidectomy," I said "No removing the lump," he said "Yeah." 

My girlfriend commented on the look on my face, when he used radical I knew that it wasn't probably just going to be removing the lump. So then my doctor came round with a consent form and said, 'Did I have any questions before I signed it?' I said "Yeah one big question that's burning inside me what are you actually going to do?" He said, "We're removing the testicle." And I just looked at him in amazement. 

And I remembered back to the Monday that I was told that I was going to have the operation and I remember his exact words "We are going to remove the lump." At no point did he say that we are going to remove the testicle. So I sat there in amazement. I signed the form. I wasn't going to go back. I knew that it was the best thing for me. He said that operating on a testicle with a lump on it, if it was cancerous that would encourage the cancer to spread. So I then went on to ask him if it was cancer what would then be the procedure. He said that I'd be asked back in for a CT scan and then obviously further treatment if required. So again I just, it all came to me, it was three hours till the operation and they tell me this. It was not good timing.
 


It is very rare that cancer occurs in both testicles. However, this can happen. One man describes how he had his left testicle and part of his right testicle removed the first time he had surgery. After chemotherapy, and radiotherapy to the right testicle, he eventually had to have the rest of the right testicle removed too.

Describes the first operation and the shock he felt when he had to have the rest of the second. testicle removed.

Describes the first operation and the shock he felt when he had to have the rest of the second. testicle removed.

Age at interview: 39
Sex: Male
Age at diagnosis: 35
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Because I had the double orchidectomy, when I woke up I was in quite a bit of pain, just because you can't even favour one side or the other. And that was another thing that surprised me is that nobody said is that the incisions are actually taken on your lower stomach  where you'd think if you've got testicular cancer you know you'd go through the scrotum. I, I just assumed that it would be through that, so that surprised me afterwards.

So basically you gave him permission to remove both testicles?

To do whatever, whatever he thought was necessary and the upshot was that my left testicle was completely removed and my right testicle was partly removed. The reason for saving part of the organ is to allow the body to continue to generate some hormones otherwise, then you might as well take, take the pair of them off. So he, he was very pleased with his, his work and I then got referred to a cancer specialist at a different hospital.

And I think it was about a, about a month from when I first felt ill to when I had surgery for the second time. Which was quite strange. I, I think it, my blood tests were normal, my blood tests were, they had taken a number when I first went to hospital, all the way through and it wasn't until, I think the week before my operation that my cancer markers went up again. And then the week after my operation they went down. So it was quite strange. But that was a, a bit of a shock.
 


The operation itself is usually quite straightforward. It was described as no worse than a hernia or minor knee operation. It may be done as a day case, but men usually stay in hospital overnight.

Many of the men we spoke to were surprised to learn that the testicle would be removed through the groin area. One described the operation in detail. Another man recalled what it was like to have an anaesthetic. He was pleased that the surgeon had spoken to him immediately after the operation, in the recovery room, reassuring him that the operation had gone well.

Explains the operation in detail.

Explains the operation in detail.

Age at interview: 28
Sex: Male
Age at diagnosis: 27
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Right, so a week later I went into the hospital for the operation. You go in the day before, you're not allowed to eat for about 12 hours before the operation, so it's nil by mouth. And then it was, this is the bit that sort of got me, they came round, the doctors, and said "We're going to do the operation, we're going to remove the whole testicle," and they started drawing on me as to where they were going to make the incision, but they started drawing across the groin. And I thought hold it, that's a little bit funny, I said "I'm coming here to have one of my testicles removed." They said "Yeah we take, we do it from the groin downwards." Because I thought they'd make the incision upwards through the scrotum and take it out but they didn't. So what they do they make the incision across the groin and they go down, take out the testicle, take out all the tubes as well that are linked to it, but more importantly they also go down because they need to check from the testicle up to the stomach that it hasn't spread upwards as well. 

So that's what they did, basically made the incision across the groin, took it out. It's only about an hour and a half operation yeah, to be honest with you it was very, when I woke up after the operation it was no pain then because you're still under the anaesthetic but as soon as the anaesthetic wore off it was very painful, couldn't really move around in bed, it was hard to sleep at night, constantly on painkillers when I could have them, when they allowed me to have them. And then it was probably about another 2 days before I went home. Could've gone home the next day but I didn't want to go home because of the, having kids so young, jumping all over you and sort of welcoming you home. So I went home about 2 days after the operation and then it was basically probably about 3 weeks convalescing. 
 

Recalls what it is like to have a general anaesthetic.

Recalls what it is like to have a general anaesthetic.

Age at interview: 33
Sex: Male
Age at diagnosis: 32
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So after a, sort of a few hours of sitting about in the waiting area I was taken through for my surgery. It was quite bizarre because I'd never had a general anaesthetic before; I was quite fascinated to see what it would feel like. And it was quite peculiar, I was taken to the sort of preoperative area, spoke to the anaesthetist, we discussed you know allergies, that sort of thing. 

They, they put a drip in my hand and then took me through to the operating theatre. He was then discussing with me what he was gonna do. He, he injected the anaesthetic into my, into the drip and said 'Just you know, breathe normally,' and I could feel, I could actually feel the anaesthetic actually, it was almost like I was inhaling it, I could feel it in my lungs almost. And then there was just ' You know, lights out. 

So I came to some time later, to be honest I'm not entirely sure; I was still quite groggy from the anaesthetic, to be offered tea and toast from the, from one of the nurses. I thought that's a great swap one testicle for some tea and toast! The urologist you know came to see me in the post operative area and said the operation had gone very well, you know she was very pleased with it, with how it had gone and that was quite nice because you know it was nice to see that person so soon after the operation and you know and get that, even just that small nugget of reassurance, just to sort of see you through that initial period after the operation.
 


A few men we interviewed felt very little discomfort after the operation, and if no more treatment was required, they soon resumed normal activities such as swimming. However, most of the men experienced some pain and took two or three weeks to fully recover. One man described how he lay on the sofa during the first week after surgery, with his wife 'waiting hand and foot'. Another man explained that he wasn't allowed to lift anything heavy after the operation, and he wasn't allowed to drive for five weeks. Another man recalled that he was off work for two weeks and was driving after just two weeks.

Recalls that he recovered rapidly after the operation, and asserts that there is nothing to worry about.

Recalls that he recovered rapidly after the operation, and asserts that there is nothing to worry about.

Age at interview: 53
Sex: Male
Age at diagnosis: 53
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I was, I came out of the hospital on the Thursday - and I like to swim a lot for health reasons - and on the following Monday I was swimming and by the end of the week I was back to my swimming my usual mile a day. There's no, there was no pain whatsoever and in actual fact things like swimming and having hot baths helps it to heal up. As I said the only thing was a nuisance was when the pubic hairs were growing back, that was the only thing that caused me any - uncomfortable. And they seemed to catch on to your underwear and everything else so all that, so that was basically the only thing. No, there is nothing to worry about. There is really nothing to worry about.
 

Describes the discomfort he felt, and the wound that had to be dressed by the local nurse after he got home.

Describes the discomfort he felt, and the wound that had to be dressed by the local nurse after he got home.

Age at interview: 32
Sex: Male
Age at diagnosis: 27
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Yes after I had the day surgery I was possibly going to get home that night but I was still too groggy from the anaesthetic. I was getting a reasonable amount of pain and I could've either come home or been given morphine for the pain I was having, and I decided to take the morphine, which they wouldn't let me go home with, so I stayed in overnight and I was allowed home the following afternoon. 

Now the way the surgery left you, it was explained to me by the surgeon beforehand that I would be extremely uncomfortable afterwards and he was right, there's no doubt about it. I had 15 staples, yes 15 staples which, metal staples in the area of the surgery er from on the left side a couple of inches below the belly button, stretching down to the area of the tumour. Now that, there was, the area of the wound had to be dressed every day, which involved the local nurse, practice nurse to come out to the home and bathe the area and change the dressing. Which again is another part of the illness, a complete stranger is coming round to your house and changing dressings in a very private part of your anatomy but again you get used to it very quickly. 

I found it difficult to sit up for a couple of days. You can't really bend over, put your shoes on, put your socks on, it leaves you a little bit immobile for a few days. But after that I found things came back quite quickly in terms of I'd say about a week later I was walking around, certainly wouldn't have considered (laughs) running or doing any sort of exercise for sort of, for three weeks to a month but after a week you're quite mobile.
 

Recalls that he was advised not to lift heavy objects after the operation.

Recalls that he was advised not to lift heavy objects after the operation.

Age at interview: 37
Sex: Male
Age at diagnosis: 37
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But it wasn't that painful but it wasn't that discomfort it was just that you couldn't lift anyone because of the hernia area. I wasn't allowed to lift for six weeks, I wasn't allowed to drive for, well, they said five weeks on this particular case. But children it was, I think I wasn't allowed to lift for six to eight weeks I wasn't allowed to lift the children or anything over so many stone. So I mean like my baby, I could lift my baby up after about a month but I wasn't allowed, they said if you start with the next child, which is a lot, he's a lot heavier, it would have been too much for me and I could have then torn myself inside and bled and then have to go back to hospital. So you have to be very careful about lifting things of any weight. So my advice is if you can get away without lifting anything, don't lift anything. I mean books and reading material no problem, but anything of any substantial weight.

Recalls that he was advised not to drive for two weeks after the operation.

Recalls that he was advised not to drive for two weeks after the operation.

Age at interview: 33
Sex: Male
Age at diagnosis: 26
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I remember being bent double really up until the Saturday when I went home, I was still walking very slowly. And they tell you not to drive for 2 weeks because obviously the force of breaking [the car] is likely to send a shock wave up your leg; that the first area it hits is your groin. So I was off work for 2 weeks, I remember going into work, probably after the first week, just to have a chat with people really and I was chatting to everybody, it wasn't just the chaps I was chatting to, I was chatting to all the girls, the secretaries and everybody. It was a fairly small company and I knew everybody and I wasn't embarrassed by it. I mean everybody; every chap has got them so why be embarrassed by it.
 

After surgery some of the men felt that their self-image and feelings of masculinity had been affected, at least for a while (see 'Masculinity and self-image').

Last reviewed December 2017.
Last updated
December 2017.

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