What is a bilateral orchiectomy?

A bilateral orchiectomy is a procedure in which the doctor removes a man's testes.

When is it used?

This procedure is usually done when you have cancer in your prostate gland. Removal of the testes, which make most of the male hormones, can reduce the amount of these hormones in the body. If there are fewer male hormones in the body, prostate cancer may grow more slowly.

In very rare cases both testes may be removed because they have a cancer that arose within the testes.

Examples of alternatives to this procedure are:

• taking female hormones

• taking injections that block the production of male hormones

• taking oral medication that blocks the production or effects of male hormones (antiandrogen pills)

• having chemotherapy

• having radiation therapy

• choosing not to have treatment, recognizing the risks of your condition.

You should ask your doctor about these choices.

How do I prepare for a bilateral orchiectomy?

Plan for your care and recovery after the operation.

For 1 week before your surgery, do not take aspirin, ibuprofen (such as Motrin or Advil), or any other nonprescription pain relievers except for acetaminophen (such as Tylenol). You may take acetaminophen for pain.

Follow any instructions your doctor may give you. Eat a light meal, such as soup or salad, the night before the procedure. Do not eat or drink anything after midnight and the morning before the procedure. Do not even drink coffee, tea, or water.

What happens during the procedure?

You will be given a general, spinal, or local anesthetic. A general anesthetic will relax your muscles and make you feel as if you are in a deep sleep. Both local and spinal anesthetics will numb part of your body while you remain awake. All three types of anesthesia should keep you from from feeling pain during the operation.

The doctor will make a cut in your scrotum and remove the testes. The doctor will then close the cut.

You can ask your doctor to insert a prosthesis or artificial replacement for the testes in your scrotum to give the look of a normal scrotum.

What happens after the procedure?

You may leave the hospital within a day. Wear a supporter and avoid strenuous work or lifting for a few days after the operation.

After this operation you may gain weight, lose your sex drive, and not have erections. You will be sterile after this procedure.

Because of the far-ranging effects of this operation, you will want to talk to your doctor about your concerns. Your doctor may refer you to a therapist for counseling.

You should ask your doctor what other steps you should take and when you should come back for a checkup.

What are the benefits of this procedure?

The cancer may grow more slowly or even stop growing. You may have less pain in areas where the cancer has spread to the bone.

After this procedure, you do not need to take female hormones, injections, or antiandrogen pills, which are expensive and must be taken continuously.

What are the risks associated with this procedure?

• There are some risks when you have general anesthesia. Discuss these risks with your doctor.

• A spinal or local anesthesia may not numb the area quite enough and you may feel some minor discomfort. Also, in rare cases, you may have an allergic reaction to the drug used in this type of anesthesia. Spinal and local anesthetics are considered safer than general anesthesia.

• The cancer may not go away, and further treatment may be needed.

• There are risks of infection and bleeding.

You should ask your doctor how these risks apply to you.

When should I call the doctor?

Call the doctor immediately if:

• You develop a fever.

• You develop a great deal of swelling in your scrotum shortly after the operation.

• You cannot urinate.

Call the doctor during office hours if:

• You have questions about the procedure or its result.

• You want to make another appointment.