If your doctor suspects testicular cancer after conducting diagnostic tests, he or she recommends surgery to remove the testicle in which the tumor was found.
Radical Inguinal Orchiectomy
Surgeons use a radical inguinal orchiectomy to remove both early and more advanced testicular tumors. For men with larger tumors, doctors may recommend chemotherapy before surgery.
During the procedure, the doctor makes a small incision in the lower groin. He or she pushes the testicle up from the scrotum through the incision and removes it. This procedure, which lasts about an hour, is usually performed on an outpatient basis. Sometimes general anesthesia is given, and other times a regional anesthetic is used. Men can usually return to regular activities within one to two weeks.
Tissue from the tumor is sent to an NYU Langone pathologist—a doctor who studies diseases in a laboratory—who can determine the type of testicular cancer. This helps your doctor develop a treatment plan to best eliminate the cancer.
When a testicle is removed, a prosthetic testicle made of saltwater encased in a silicone shell may be inserted in its place for cosmetic reasons, if you wish.
Retroperitoneal Lymph Node Dissection
If laboratory tests after a radical inguinal orchiectomy indicate that a tumor is likely to metastasize, or spread to other parts of the body, you may need additional surgery.
Doctors often recommend removing the lymph nodes—small glands located throughout the body that help to filter out foreign matter, such as bacteria and viruses—in the area behind the abdominal organs. Testicular cancer often first spreads to lymph nodes in this area. This procedure is called a retroperitoneal lymph node dissection.
A combination of the surgeries to remove the testicle and abdominal lymph nodes may cure many early nonseminoma tumors. Research shows that men with advanced testicular cancer who have lymph node surgery after chemotherapy may be able to further reduce the risk of cancer recurrence.
Managing Side Effects
Men who have had one testicle removed usually continue to have normal sexual function and fertility, since only one testicle is needed to maintain hormone production. Removal of the testicular tumor can even improve fertility if the tumor suppressed sperm production.
Removing the lymph nodes around the testicles may disrupt the nerve pathways that control ejaculation. NYU Langone urologic surgeons are skilled at preserving these nerves and reducing the impact on fertility and sexual activity.
If you are concerned about a loss of fertility, our experts can refer you to NYU Langone’s Fertility Center, where specialists can advise you on banking or freezing sperm before surgery.
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