Subcapsular orchidectomy

Occasionally an operation called a subcapsular orchidectomy (or radical orchidectomy) is done to remove the part of the testicles that produces testosterone. This reduces the level of the male hormone testosterone and helps control the prostate cancer and reduce symptoms. Both testicles are operated on (bilateral orchidectomy). It’s mostly used in men who can’t or don’t want to have other types of hormonal therapy.

A subcapsular or radical orchidectomy is a simple operation. A small cut is made in the scrotum (the sac that holds the testicles), and the part of the testicles that produces testosterone is removed. After the operation the scrotum will be smaller than it was before. You usually have this operation as a day patient under a local or general anaesthetic.

After the operation, you’re likely to experience some pain, and some swelling and bruising of the scrotum. You will be given painkillers to ease any pain. You’ll also start to have side effects similar to those of hormonal therapy drugs, which include hot flushes and loss of erections.

Some men find the idea of this operation distressing. You may find it helpful to talk through the procedure with your cancer specialist. They will give you more information about what it involves.

Advantages of subcapsular orchidectomy

  • It’s a simple operation that avoids the use of drugs and some of their side effects such as breast swelling and tenderness.
  • It’s equally effective as other hormonal treatments.

Disadvantages of subcapsular orchidectomy

  • Some men find the idea of this operation difficult to cope with. 
  • There are some risks and side effects associated with surgery. Your specialist will give you more information about these.
  • It can’t be reversed once the procedure has been carried out. It’s therefore not a good option for men who only need short-term hormonal therapy. If you are thinking about having a subcapsular orchidectomy talk to your doctor about this.

Back to Hormonal therapies explained

Types of hormonal therapy

There are different types of hormonal therapy used to treat advanced prostate cancer. You may have more than one type.

Ways of giving hormonal therapy

There are different ways of having hormonal therapy for advanced prostate cancer. Your doctor will discuss with you which they think is best for your situation.