Urology And Urosurgery
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Orchiectomy is the removal of one or both testicles (testes). The testicles are the male sex organs that produce sperm and the male hormone, testosterone.
An orchiectomy is a common treatment for testicular cancer. It may also be done to treat other conditions such as prostate cancer or in the event of severe trauma to one or both testes.
Figure : Male Pelvis : Side View
What are the types of Orchiectomy?
Orchiectomy can be:
- Unilateral Orchiectomy -
Only one testicle is removed, either the right or the left.
- Bilateral Orchiectomy or Radical Orchiectomy -
Both the testicles are removed
- Inguinal Orchiectomy -
The operation is performed through an incision in the groin
- Scrotal Orchiectomy -
The operation is performed by making an incision through the scrotum.
Who is an ideal candidate for Orchiectomy?
If you have cancer of the testicle(s), if you have suffered any injury or trauma to the testicle(s) or if you have advanced prostate cancer that might have spread to the testes, then you are an ideal candidate for Orchiectomy. Cryptorchidism or Undescended Testes has a higher risk of testicular cancer. This increased risk does not change even after the surgery is performed to move the testicles down in the scrotum. In some high risk candidates (those with a family history of testicular cancer), a prophylactic Orchiectomy might be indicated. It is important for your physician to exclude orchitis (inflammation of the testes which can also present as swelling and lump in the scrotum) before performing Orchiectomy
During the procedure, a small incision is made in the lower abdomen just below the belt line. The testicle is then pushed up from the scrotum through the incision and removed. The procedure is usually finished in less than an hour.
What To Expect After Surgery?
Orchiectomy can be done as an outpatient procedure or with a short hospital stay. Regular activities are usually resumed within 1 to 2 weeks, and a full recovery can be expected within 2 to 4 weeks.
Why It Is Done
Orchiectomy is always performed when testicular cancer is suspected. This is because testicular lumps are often cancerous and must be removed as part of treatment. Also, performing a biopsy on a testicle before it is surgically removed can cause cancer cells to spread, making successful treatment more difficult.
Sometimes bilateral orchiectomy (removal of both testes) is necessary, though this is rare.
How Well It Works?
Orchiectomy is the most effective way to remove cancerous tumors of the testicles. In some cases, orchiectomy is followed by additional surgery to remove cancer that has spread or by adjuvant therapies such as chemotherapy or radiation therapy.
In some cases of early-stage testicular cancer, orchiectomy is the only treatment necessary and is followed only with a watchful waiting program. Watchful waiting, or surveillance, is a period of time during which you and your health professional observe your symptoms or condition without using medical treatment.
Testicular cancer is a very curable form of cancer, especially if it is diagnosed and treated at an early stage. Orchiectomy is important to the successful treatment of this disease and offers the best chance for cure.
You will spend a couple of days after Orchiectomy operation in the recovery room under observation to monitor your vital signs, heart and lung function and watch for excessive bleeding. Use ice for the first 24 hours followed by heat (at the site of operation) to relieve pain and swelling. Pain medication and antibiotics will be prescribed to prevent infection and alleviate pain and discomfort. You will be instructed to wear a scrotal support (jock strap) for 3 - 4 days and will be allowed to go home after 2 - 3 days. You will be ready to resume your daily activities in about a month and will be instructed to come in for regular follow up for the next 5 years if Orchiectomy was performed for the treatment of testicular cancer or prostate cancer. Keep your incision clean and dry, carefully clean the scrotal area when you bathe or shower and change your dressing.
Benefits of Orchiectomy
Orchiectomy is an effective way to remove testicular tumor and may or may not need chemotherapy or radiation therapy after the operation. Orchiectomy may relieve bone pain and may cause the prostate cancer to shrink.
Orchiectomy surgery is relatively low-risk, and complications are uncommon. However, orchiectomy carries all the risks of any major surgery, including:
Bilateral orchiectomy (removal of both testes) is rarely done and carries the possibility of side effects. They are related to the loss of testosterone following the removal of both testes. These include:
- Reactions to anesthesia or medications.
- Loss of sexual interest.
- Erection problems.
- Hot flashes.
- Breast enlargement (gynecomastia).
- Weight gain.
- Loss of muscle mass.
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