Surgery for testicular cancer

Removing the testicle (orchidectomy) may be the only treatment needed for very early testicular cancer. It’s also necessary to diagnose the cancer.

You may have tests before surgery. If you smoke try to stop. This helps with your recovery after the operation. You can often go home on the day you have surgery or the day after.

You’ll be given a general anaesthetic. The surgeon makes a cut in your groin to remove the testicle. They can insert an implant into your scrotum so that it still looks the same.

The area may be swollen, bruised and uncomfortable for a few weeks. Taking regular painkillers will help. You usually have stitches that self dissolve.

You can have sex when your wound has healed. The operation won’t stop you from being able to father children if there are no problems with your other testicle.

Occasionally men with testicular cancer need further surgery. This may be to remove the lymph glands at the back of the tummy (retroperitoneal glands) or to remove signs of cancer in the lung or liver.

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Removing the testicle (orchidectomy)

As well as confirming a diagnosis, an orchidectomy removes the cancer. It is the main treatment for testicular cancer when it has not spread. If the cancer hasn’t spread outside the testicle, and there’s a low risk of it coming back (recurrence), this may be the only treatment you’ll need.

During the operation, the surgeon can insert an artificial testicle (known as an implant or prosthesis) into your scrotum. If you’re unsure about whether you want this, you can have a prosthesis put in at a later date. Your specialist will give you more details about the benefits and disadvantages of having an artificial testicle, and how it will look and feel afterwards.


Before your operation

If you smoke, try to give up or cut down before your operation. This will help reduce your risk of chest problems, such as a chest infection, and will help your wound heal after the operation. 

Your GP can give you advice, and you may find it helpful to read our leaflet Giving up smoking. You may meet a member of the surgical team and a specialist nurse to discuss the operation. This may be at a pre-assessment clinic before you’re admitted for your operation. Make sure you ask any questions or talk over any concerns you have about the operation. You may have some tests before the operation, such as an ECG (a recording of your heart).

You’ll usually be admitted to hospital on the morning of the operation. You’ll meet a member of the surgical team and nursing team. You’ll also meet the doctor who’ll give you your anaesthetic (the anaesthetist). They’ll be able to answer any questions you have about the anaesthetic and pain control after the operation.


The operation

Your operation will be done under a general anaesthetic. The surgeon will make a small cut (incision) in the groin on your affected side. The testicle is pushed up from the scrotum and removed through the incision on your lower tummy.


After the operation

Once the anaesthetic has worn off you’ll be able to eat and drink. You’ll be encouraged to get up and start walking around as soon as possible. As soon as you feel well enough and you’ve been checked over by your doctor, you can go home. This may be on the same day or you may need to stay in overnight. You will need someone to take you home and stay with you for the first 24 hours after going home.

It’s not unusual to have some discomfort, bruising and slight swelling around the scar for a couple of weeks, but this can usually be controlled with painkillers. Wearing supportive underwear and loose trousers might help you feel more comfortable. You may have numbness around the area, but usually this gradually improves. However in some men, it may always feel a little different to the unaffected side.

You usually have dissolving stitches. They can take a few weeks to completely dissolve. Non-dissolving stitches tend to be removed about 5–10 days after your operation. Your specialist will advise you not to drive or do any heavy lifting for several weeks after your operation. The amount of time you’ll need to take off work will depend on the type of work you do.

Sex

You’ll be able to get back to your normal sex life once your wound has healed. You may not feel like having sex for a while after your surgery. This may happen if you’re in some discomfort and feel anxious. Some men are concerned about their appearance after they’ve had a testicle removed. Most men find that any negative feelings gradually go away. But if you continue to struggle with difficult feelings or problems with your sex life, talk to your doctor or specialist nurse. They can suggest sources of help and support

Fertility (being able to father children)

You will still be able to have children after an orchidectomy. However, some men may already have fertility problems, or their unaffected testicle may be small and possibly producing less sperm. In this case, men may be offered sperm banking before their operation. Sperm banking involves freezing your sperm so that it can be used in the future to help you and your partner have a child. Your cancer doctor or specialist nurse can discuss this with you before your treatment starts.


Removing the lymph nodes at the back of the tummy (retroperitoneal lymph nodes)

Some men need further surgery after they have had chemotherapy. Sometimes a CT scan shows that the lymph nodes at the back of the tummy (abdomen) are enlarged (greater than 1cm in diameter). This means the nodes may contain cells that could become cancerous in the future. Surgery to remove them is the only certain way of finding this out.

Rarely, these lymph nodes are removed in men with an early‑stage non-seminoma who are unable to have surveillance appointments or adjuvant chemotherapy. This will show whether the cancer has spread and remove any nodes that might be affected. Surgery to remove the retroperitoneal lymph nodes is called a retroperitoneal lymph node dissection (RPLND).


Surgery to other parts of the body

Occasionally, after chemotherapy, some men may develop signs of cancer in areas such as the lungs, brain or liver. They may need to have further surgery. These operations are done by experienced surgeons in specialist units. If you need this type of operation your doctor will talk it over with you.

Back to Surgery explained

What happens after surgery?

You’ll be monitored very closely after your operation. You will be very tired so it’s important to rest and look after yourself.