Treatment

An ‘Inguinal Orchidectomy’ is the removal of a testicle through an incision in the area of the groin. This area is otherwise known as the inguinal region.

There are a number of reasons why an ‘Inguinal Orchidectomy’ may be needed, some of these are:

• If a testicle remains undescended from childhood and it cannot be brought down into the scrotum surgically, it must be removed. This is because there is a risk of developing cancer in the undescended testicle.
• If a testis is atrophic, which means it has wasted away due to lack of blood, nourishment or nerve supply, it needs to be removed otherwise it can cause pain and infection in the future.
• If cancer of the testis is suspected, the testis containing the tumour needs to be removed. This is so that the tumour can be studied under a microscope to see what cells it is made up of. Depending on the outcome of these results, appropriate treatment can be given as soon as possible, if this is necessary.

In the first two cases, when an inguinal orchidectomy is performed to remove one testicle, your fertility should not be affected and may in fact improve. This is because the remaining healthy testicle will continue to function in the normal manner to maintain fertility and produce male hormones such as testosterone. When cancer of the testicle is present, fertility may be affected, not by surgery itself but by the follow-on treatment that may be required. If fertility is likely to be effected then sperm banking is advised and arranged for younger men.

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. Your doctor and the nurse will discuss these with you, should you have any questions, your nurse or doctor would be happy to answer these.

If you would like your testicle returned to you for personal reasons, please discuss this with your family and inform your nurse and surgeon before your operation.

It would be a very rare occurrence to require a blood transfusion with this surgery. However, in the unusual event that you did need a blood transfusion and you want to refuse one, it is vital that you tell your surgeon and nurse prior to 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 two 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, Epidural or 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 may be sleepy and you will not feel the operation.

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.

You may need a shave of the surgical site, this is usually done just prior to going to theatre or in theatre itself 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 an drip in your arm and attach various monitoring devices.

Once you have been completely prepared and given your anaesthetic, surgery will begin. The operation usually takes about 45 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 temperature routinely and your wound will be checked regularly. You may still have the drip in your arm so you get enough fluid until you are drinking normally. You can usually eat and drink when you return to the ward.

Once you have recovered from your anaesthetic your nurse will help you, to get out of bed for the first time. You will be able to be up and about, but you must take things very quietly in order to avoid causing any bleeding or bruising of the operation site. To make things more comfortable when you are up, you may wish to wear a pair of your own firm fitting underpants, which will help support the operation site.

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 get 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 incision. 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 4-6 weeks after your operation.

If you have suspected testicular cancer, you would be seen much sooner after your operation to follow-up on your test results. You would have a CT Scan, which is a special type of X- ray that provides pictures of cross sections through the body. It is painless and usually takes about 30-40 minutes. The results of the CT Scan, and other tests would be discussed with your urologist at a clinic appointment soon after your operation. From the test results your urologist will be able to determine if you will need further treatment to help cure the cancer.

If you do require further treatment, the options would be discussed with you and you would be referred to the appropriate specialists so you can start treatment as soon as possible.

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

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

Your wound should heal superficially within three to five days. During this time, your wound may ooze very slightly. However, 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 this can cause the stitches below the skin to pull apart. Other than avoiding these activities, you will be able to carry on with your normal daily routines as you feel able.

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.