Orchiectomy with or without testicular prosthesis
What is it?
The orchiectomy surgery consists in the surgical removal of the testicle (or of the testicle and the spermatic funiculus (orchifunicolectomy) - in case of procedure performed for testicular tumor) that is performed through a small incision of about 4 cm at the inguinal level. This procedure has both dignostic and therapeutic value in the treatment of testicular cancer. At the end of the intervention, it is possible to place inside the scrotal sac a prosthesis, more commonly in silicone, in order to improve the aesthetic aspect after the intervention.
When is this procedure indicated?
This procedure is indicated in case of testicular cancer and in case of other non-oncological testicular pathologies of infectious nature, post-traumatic or in case of ischemic suffering in the context of a testicular torsion (in the latter cases the surgical access can be through the scrotal rather than inguinal).
In cases of cancer, it is necessary to perform an orchifunilectomy, which involves careful isolation of the spermatic cord in the inguinal canal and the testicle and their subsequent removal.
How is it performed?
The intervention is performed under general or spinal anesthesia and has variable duration but generally less than an hour. In most cases, the patient is discharged the day after surgery and can return to usual daily activities within a few days, taking care to avoid physical exertion and sexual activity for about 2 weeks.
This procedure, often performed in young adult patients, can result in psychogenic trauma with potential consequences for body image and sexual well-being. Implanting a testicular prosthesis can help reduce the discomfort resulting from testicular removal surgery. The prostheses currently available on the market are made of compounds of silicone gel or saline solution, of different sizes, very similar in aesthetic and biomechanical characteristics to the native testis. If requestd by the patient, the implant can be performed simultaneously with the orchifunicolectomy if there are no contingent local contraindications; through the same surgical access, the prosthesis is positioned and fixed in the scrotum. Alternatively, prosthetic implantation can also be performed at a later date through a second surgical procedure.
Recovery
Recovery following this type of surgery is very rapid. Generally the pain is very well controlled and does not affect normal daily activities. It is very important, however, that the patient avoids intense physical exertion, trauma and sexual activity for 2 weeks following the procedure.
Short-term complications
In the first days after the procedure, the patient may experience local pain at the site of the procedure, which is generally well controlled with targeted drug therapy. It is also possible that there is reduced skin sensitivity at the site of the surgical incision, which tends to resolve itself in the first 2-4 weeks. Local infections or hematomas following surgery are rare.
Long-term complications
In the long term, if a testicular prosthesis has been placed, infections of the prosthetic material may occur, the treatment of which involves removal of the implant.
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