Treatment

This surgery is a form of hormone treatment for patients with prostate cancer. It is done to decrease the levels of the male hormone testosterone, which influences most prostate cancer growth. Testosterone is mostly made by the testicles so removing them also removes approximately 90% of the testosterone produced by the body. The remaining testosterone can be controlled by tablets or injection therapy.

Lowering the testosterone levels with a Bilateral Orchidectomy does not cure prostate cancer, but it may slow its growth and keep the disease in check for years.

After having the testicles removed, one side effect may be the occurrence of hot flushes. This is due to the lowered levels of testosterone and tends to affect approximately 25% of patients. If these hot flushes become troublesome they can generally be controlled with a small dose of medication.

Also after surgery, many patients may notice a loss of sexual desire and the ability to have spontaneous erections. For these patients treatment options are available to help them return to normal potency. These options can be discussed further with your Urologist.

Other male characteristics such as your voice are generally unaffected by this surgery. Recovery from surgery is rapid and you should be able to return to normal activities soon after your operation.

Your Consent

We need your permission for your operation to go ahead. Before you sign the consent form it is important that you understand the risks and effects of the operation and anaesthetic. These will be discussed with you by your Specialist or one of our nurses.  If you have any questions please do not hesitate to contact us.

If you would like your testicles returned to you after surgery for personal reasons, please discuss this with your nurse or surgeon before your operation.

About Your Anaesthetic

You will NOT be allowed to eat or drink anything for at least six hours before your surgery. This includes chewing gum and sweets.

There are three main types of anaesthetic used for this surgery;

• General Anaesthetic: You will be asleep throughout the operation and remember nothing of it.
• Regional Anaesthetic e.g. Spinal, Epiduralor Caudal: A needle is placed into your back and a solution is injected that will numb your body from the waist down. You will be awake but you maybe sleepy and you will not feel the operation.
• Local Anaesthetic: A needle is placed into your back and a solution is injected that will numb your body from the waist down. You will be awake but you maybe sleepy and you will not feel the operation.

Local anaesthetic is only used on rare occasions where patients may have  severe, pre-existing medical problems. With local anaesthetic patients are awake for the operation but the area to be operated on is totally numbed.

Feel free to discuss these options, and your questions with the anaesthetist.

You must not drive any vehicle or operate any machinery for 24 hours after having an anaesthetic. You will have to arrange for someone to drive you home if you go home within 24 hours of your surgery.

Your Operation

On admission, you will be informed of your approximate time of surgery and prepared for theatre by your nurse.

A full scrotal shave is required for surgery; this is usually done in the theatre once you are asleep. You may be given some tablets before theatre. These are charted by your anaesthetist and may include tablets for tension, nausea and pain prevention.

You will be escorted to theatre where you will be transferred to the theatre table. Anaesthetic staff will then insert a drip in your arm and attach various monitoring devices. Once you have been completely prepared and given your anaesthetic, surgery will begin. The operation takes about 30 minutes.

When the operation is completed, you will go to the recovery room for a short while where you will be cared for until you are ready to be transferred to the ward.

After Surgery

Your nurse will check your blood pressure, pulse and wound routinely.

You may still have the drip in your arm so you get enough fluid until you are drinking normally. You can eat and drink when you return to the ward.

You may have a scrotal support in place, which is a special pair of underpants that support the scrotum. These underpants help prevent bleeding and keep you comfortable.

Your nurse will help you get out of bed for the first time once you have recovered from your anaesthetic. If you had a spinal anaesthetic, you may be asked to lie flat for several hours after returning to the ward to allow for the anaesthetic to wear off.

Our aim is to keep you as comfortable as possible, so please tell your nurse if you have any pain or discomfort so you can be given the appropriate care. At all times, your nurse is there to help you, please ring your bell if you need assistance and your nurse is not nearby.

Going Home

Once you are up and about, eating and drinking and you have passed urine you will be able to return home. This may be later on your operation day or the following morning.

Before leaving the ward you will be given a discharge information letter which contains helpful information for when you go home.

Your nurse will give specific instructions about caring for your wound. Usually you would be asked to wash your wound daily, ensuring you do not use soap directly on the cut. The area should be kept clean and dry and you will be given a supply of dressings to take home that are to be placed over the wound to collect any slight ooze.

You will be given or sent an outpatient clinic appointment to return to see the specialist. The appointment is usually about 6 weeks after your operation or sometimes in 3 months with a check PSA (prostate hormone level) beforehand.

We will send a letter to your own doctor about your operation and the details of your treatment while you were in hospital.

Once Home

You should wear your scrotal support or your own supportive underpants for as long as you need, for comfort after your surgery. This helps keep you more comfortable and aids healing. (You should bring a pair of your own supportive underpants to the hospital with you to go home in, just in case there are no scrotal supports available).

Your wound should heal and stop oozing within three to five days. If your wound continues to ooze or you have any signs of an infection, such as a red, hot, swollen, or painful wound please contact your own doctor as soon as possible.

You should avoid any heavy lifting, straining or strenuous activity for 4 weeks after your surgery as such activities can cause the stitches under the skin to pull apart. You will be able to carry on with your normal daily routines as you feel able.

Before discharge your nurse will inform you about taking mild pain relievers, should you have any pain or discomfort after you return home.

This is routinely a straightforward operation, after which most patients have a speedy recovery and experience little pain.

While you are in hospital we will do everything we can to make your stay as comfortable as possible. The nursing and medical staff are always available to help with whatever needs you have. If you are worried about anything before or after your surgery, or if you have any further questions or would like more information, please do not hesitate to ask your nurse who will be more than happy to help.