FAQs: High Inguinal Orchiectomy
(Surgery for Testicular Cancer)
Section 1: The Procedure
Q: What is a High Inguinal Orchiectomy? A: This is the surgical removal of a testicle and the spermatic cord. It is the primary treatment for a suspicious testicular lump or confirmed cancer.
Q: Why is the incision in my groin and not the scrotum? A: This is a crucial safety measure. Testicular cancer cells can spread through lymphatic channels.
The Scrotum: Has a different lymphatic drainage system (to the groin/skin). Cutting through it could accidentally spread cancer cells to these areas.
The Groin Incision: Allows us to remove the testicle and the entire spermatic cord "en bloc" (as one piece) high up, ensuring no cancer cells are left behind in the drainage tubes.
Q: Will I be asleep? A: Yes. The procedure is typically performed under general anesthesia (you are completely asleep) or spinal anesthesia (numb from the waist down). It usually takes 45–60 minutes.
Section 2: Fertility & Fatherhood
Q: Will removing one testicle make me infertile? A: No. In most cases, a single healthy testicle produces more than enough sperm to conceive a child naturally. Think of it like a kidney—you have two, but your body can function perfectly fine with just one.
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Q: Should I bank sperm (freeze sperm) before surgery? A: Yes, we highly recommend it. While your remaining testicle can do the job, we recommend sperm banking as an "insurance policy."
Why? Sometimes, the stress of cancer or surgery can temporarily lower sperm counts. Furthermore, if you need chemotherapy or radiation after surgery, those treatments can damage sperm. Banking before surgery (or immediately after, before chemo starts) guarantees you have healthy sperm stored for the future.
Q: Will I still be able to have erections and sex? A: Yes. Removing one testicle does not affect the nerves or blood vessels that control erections. Once you have healed from the surgery (usually 2–3 weeks), you can resume normal sexual activity.
Q: What about my Testosterone levels? A: Your remaining testicle will usually "step up" to compensate. It will produce more testosterone to keep your levels normal. You should not experience symptoms of low testosterone (like muscle loss or low libido). We will monitor your hormone levels during your follow-up visits just to be sure.
Section 3: Appearance (Prosthesis)
Q: Will it look obvious that I am missing a testicle? A: The scrotum is very elastic. After surgery, the empty side usually shrinks up slightly, but for many men, the difference is not immediately noticeable to others.
Q: Can I get a fake testicle (implant)? A: Yes. We can insert a Testicular Prosthesis (a silicone implant filled with saline) into the scrotum.
Timing: This can be done at the same time as the cancer surgery, or effectively done later as a separate, smaller procedure.
Feel: It is designed to feel like a natural testicle, though it may be slightly firmer and will not change size with temperature like a real one.
Choice: This is purely cosmetic. It is entirely your choice.
Section 4: Recovery
Q: How long is the recovery? A:
Hospital: Most patients go home the same day or the next morning.
Work: Desk jobs: 1 week. Physical jobs: 2–3 weeks.
Activity: You must avoid heavy lifting (over 10 lbs) for 4 weeks to prevent a hernia at the incision site.
Q: Why do I feel numbness in my inner thigh? A: The incision in the groin is near a small nerve (the ilioinguinal nerve) that provides sensation to the inner thigh and the base of the scrotum. It is common to have temporary numbness here. It typically improves over a few months.
Section 5: Next Steps (The Cancer)
Q: Does this surgery cure the cancer? A: For many early-stage cancers (Stage I), removing the testicle is the only treatment needed.
Pathology: We send the removed testicle to the lab. About 1 week later, we get a report telling us the exact type and stage of cancer.
Follow-up: Based on that report, we will decide if you need simple surveillance (regular scans) or additional treatment like chemotherapy or radiation to ensure it doesn't come back.