Surgery to remove the testicle is needed to diagnose testicular cancer. It is also the main treatment when the cancer has not spread.
The only way to get a definite diagnosis of testicular cancer is to do an operation to remove the whole of the affected testicle.
After surgery, a doctor called a pathologist examines the tissue removed, to see if there are cancer cells. They will also be able to tell which type of testicular cancer you have.
It is natural to worry about having this operation. Your specialist doctor and nurse will explain why you need it and will talk about it with you.
If your other testicle is healthy, removing one testicle will not affect your sex life. It will not affect your ability to have an erection or have children. You will be able to return to your normal sex life once you have recovered from the operation.
If you are gay, bisexual or transgender
Sometimes, people may find their doctor or nurse assumes they are heterosexual. Or their doctor may not be aware that they are transgender. You may choose to let your doctor or nurse know about your sexuality, or the gender you identify with.
If you are transgender, letting them know may make it easier when you have a physical examination.
If you are gay or bisexual, and have a partner, it can make it easier for them to come to appointments with you. And having your relationship recognised can make you both feel more supported.
As well as confirming a diagnosis, an orchidectomy removes the cancer. It is the main treatment for testicular cancer that has not spread. This may be the only treatment you will need if:
- the cancer has not spread outside the testicle
- there is low risk of the cancer coming back (recurrence).
Testicular implant or prosthesis
During the operation, the surgeon can put an artificial testicle into your scrotum. This is called a testicular implant or prosthesis. If you are unsure about whether you want this, you can have a prosthesis put in another time.
Your specialist will give you more details about the benefits and disadvantages of having an artificial testicle. They can explain how it will look and feel.
If you smoke, try to stop or reduce how much you smoke before your operation. This will help:
- lower your risk of chest problems, such as a chest infection
- help your wound heal after the operation.
Before your operation, you will meet a member of the surgical team and a specialist nurse. They discuss the operation with you.
You may go to a pre-assessment clinic to have some general checks such as blood tests and an ECG (a recording of your heart). Make sure you ask any questions, or talk over any concerns you have about the operation.
If your doctor thinks the operation may affect your fertility, they may ask if you want to store (bank) sperm beforehand. We have more information about sperm banking.
You are usually admitted to hospital on the morning of the operation. You meet members of the surgical team and nursing team and the anaesthetist.
You will have the operation under general anaesthetic. The surgeon will make a small cut (incision) into the groin on the affected side. They will then push the testicle up from the scrotum, and remove it through the incision.
When you have recovered from the anaesthetic you will be able to eat and drink. The hospital staff will encourage you to get up and start walking around as soon as possible.
As soon as you feel well enough and your doctor has checked you over, you can go home. You will need someone to take you home and stay with you for the first 24 hours once you are home.
Recovering from surgery
You may have some discomfort, bruising and slight swelling around the scar for a couple of weeks. Taking painkillers will help with this.
Wearing supportive underwear and loose trousers might help you feel more comfortable. The hospital may give you a temporary scrotal support to wear if you feel very uncomfortable.
You may have numbness around the area, but usually this will gradually improve. 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 are usually removed about 5 to 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 need to take off work will depend on the type of work you do.
You can return to a 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 are in some discomfort and feel anxious.
Some men are concerned about their appearance after they have had a testicle removed. For most men, any negative feelings gradually get better.
Talk to your doctor or nurse if difficult feelings or problems with your sex life continue.
You may be worried that the cancer will affect your ability to make someone pregnant (fertility). If your other testicle is healthy you will still be able to have children after an orchidectomy.
However, some men may have fertility problems. Or the other testicle may be small and may be making less sperm. In this case, men will usually have the option of sperm banking before their operation, if it does not delay treatment too much.