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Perhaps you or someone in your family has been told by a doctor about an orchiectomy. It's normal to feel a little scared, anxious, and have a lot of questions when you hear something like this. "Why are you doing this?", "What will happen after this?" You may be wondering. But this is not as scary as we think. Today, we will talk about this surgery called 'Orchiectomy', which means the removal of the testicles, in a very simple way that you can understand.

Simply put, what is Orchiectomy?

Orchiectomy is the surgical removal of one or both testicles . As you know, the testicles are two small organs located in a pouch of skin (scrotum) below a man's penis. They have two main functions. One is to produce sperm , and the other is to produce male hormones like testosterone . This surgery is usually done in a hospital, but in most cases it is an outpatient procedure where you can go home the same day.

Why is this surgery being performed? What are the main reasons?

There are several main reasons why doctors perform this surgery. Let's look at them.

1. As a treatment for cancer conditions

• Testicular Cancer: This is the main cause. If there is a suspicion of testicular cancer, this surgery is performed to definitively diagnose and treat it . The tissue removed during surgery is sent to a laboratory (pathologist) to confirm whether there are cancer cells.
• Prostate Cancer and Male Breast Cancer: You may be surprised, but both of these types of cancer are treated with this surgery. The reason is that male hormones (androgens) like testosterone help some cancer cells grow. Think of these hormones as 'food' for some cancer cells. When we remove the testicles, the levels of these hormones in the body decrease. Then the cancer cells are deprived of 'food', they begin to shrink and stop spreading.

2. To remove damaged testicles

Imagine being hit by a ball while playing cricket, having a bike accident, or having a serious injury to a testicle. If the doctors can't repair it, they have to remove the damaged part and sew up the surrounding tissue. Also, sometimes after a testicle twist (testicular torsion), if the blood supply to it is cut off and the testicle is damaged, it has to be removed.

How is the surgery done?

This surgery is performed under general anesthesia, meaning you are asleep and not aware of anything. Therefore, you will not feel any pain during the surgery. The doctor will make a small incision in the skin to perform the surgery. The surgical technique will vary slightly depending on where the incision is made.

If some people are a little uncomfortable with their appearance after surgery, they can have a prosthetic testicle inserted. This is just saline inside. This is completely up to you. At the end of the surgery, the doctor will stitch the incision closed. The entire surgery usually takes only 30 to 60 minutes .

Things to pay attention to during recovery after surgery

After surgery, you will need to stay in a recovery room for a while before you can go home. It is not advisable to drive on the way home, so it is important to have someone drive you home. It will take several weeks to fully recover. Take care of these things during this time.

• Avoid physical activity: Take it easy for the first few days. You may want to avoid activities like lifting weights, running, and having sex for a few weeks. Ask your doctor about the best time to start doing these again.
• Keep the wound clean and dry: Keep the area where the stitches were placed clean and dry. Take care of it as your doctor tells you. You may be asked to wear a special support garment for the first 48 hours to help reduce swelling.
• Manage pain: It is normal to have some pain, discomfort, and tenderness after surgery. Applying an ice pack for about 20 minutes can help with the pain. Talk to your doctor about pain medication.
• Drink plenty of water and eat fibrous foods: It is not good to strain while going to the toilet during this time. Therefore, to prevent constipation, drink plenty of water and eat fibrous foods like vegetables and fruits.

What are the benefits and possible side effects of this surgery?

Like any surgery, this one has benefits as well as minor risks.

When it comes to risks and side effects, bleeding and infection are common with any surgery. However, there are some side effects that are specific to this surgery, especially when both testicles are removed (Bilateral Orchiectomy) . This is because the body's testosterone levels suddenly drop. This can cause things like:

• Low sex drive
• Feeling very tired (Fatigue)
• Hot flashes
• Decreased muscle mass
• Osteoporosis
• Erectile dysfunction
• Depression

The most important thing: If both testicles are removed, sperm production will be lost. This means that the person will be unable to have children (infertility) . It is essential to discuss this with the doctor before the surgery and understand it.

Also, it is very normal to feel anxious and sad about yourself, your appearance, and your sexuality after a surgery like this. It is very important to talk about these feelings with your doctor or someone you trust.

If you have these symptoms, call your doctor immediately!

If you experience any of the following symptoms after going home from surgery, call your doctor immediately. Or go to the Emergency Department (ETU) of the nearest hospital.

• Fever or unbearable pain .
• Difficulty swallowing.
• A deep red or purple spot (hematoma) that appears at the site of the injury or in the scrotum.
• If blood or pus is oozing from the wound.
• Numbness in the scrotum.

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