Radical removal of the testis (± silicone implant)

What is this?

This involves removal of the testis via a groin incision for suspected testicular cancer. A testicular implant may be inserted at the same time if you wish

What alternatives are there?

In reality, there are often none but, occasionally, the surgeon may wish to discuss observation, biopsy or partial removal of the testis where a suspected tumour is present; these occasions, however, are very uncommon. The majority of testicular cancers can be detected by simple examination and ultrasound scanning together with blood tests (to measure tumour markers), a chest X-ray and a CT (body) scan.

What to expect before procedure

Having only one testis should not adversely affect your life. The remaining testicle takes over the function of the removed one so your sex life and ability to father children should be unchanged. However, testicular cancer and its treatments (especially chemotherapy) can alter the amount of sperm produced. You will, therefore, be given the opportunity to provide semen samples for storage. These can be used in the future for assisted conception If your fertility does not return after treatment. If you are concerned about the cosmetic results of losing a testicle, a false testicle (prosthesis) can be inserted during the operation. You will usually be admitted the day before your surgery. You will normally receive an appointment for pre-assessment, approximately 14 days before your admission, to assess your general fitness, to screen for the carriage of MRSA and to perform some baseline investigations. After admission, you will be seen by members of the medical team which may include the Consultant, Specialist Registrar, House Officer and your named nurse. You will be asked not to eat or drink for 6 hours before surgery and, immediately before the operation, you may be given a pre-medication by the anaesthetist which will make you dry-mouthed and pleasantly sleepy.

What happens during the procedure?

Either a full general anaesthetic (where you will be asleep throughout the procedure) or a spinal anaesthetic (where you are awake but unable to feel anything from the waist down) will be used. All methods minimise pain; your anaesthetist will explain the pros and cons of each type of anaesthetic to you. The testicle is normally removed through an incision in the groin (similar to that used for repair of a hernia). It may be necessary to take biopsies from the other (normal) testis; If this is needed, it will be discussed with you before the procedure. The operation takes approximately 30 minutes.

After the procedure

You may eat, drink and mobilise when you are fully recovered from the anaesthetic. You will be able to leave hospital as soon as you are comfortable, provided you have someone to collect you and to remain with you for the first 24 hours after discharge. The average hospital stay is 1-2 days.

Potential side effects