An orchiectomy surgery in Iran is done to remove one or both of your testicles. It’s commonly performed to treat or prevent prostate cancer from spreading.
An orchiectomy surgery in Iran can treat or prevent testicular cancer and breast cancer in men, too. It’s also often done before sexual reassignment surgery (SRS) if you’re a transgender woman making the transition from male to female.
An orchiectomy is the removal of one or both testicles. The testicles rest below the penis in the scrotum. The testicles are glands that make sperm and testosterone.
An orchiectomy may be used to treat some cases of:
. Testicular and/or prostate cancer.
. Male breast cancer.
. Cancer prevention in men with an undescended testicle after puberty.
. Severe trauma.
. Male-to-female gender reassignment surgery.
There are different types of orchiectomy, including:
. Radical Inguinal Orchiectomy: The testicle and spermatic cord are removed through an incision made in the groin. At times, a prosthetic saline-filled testicular implant can be inserted.
. Simple Orchiectomy: During a simple orchiectomy, the testicle is removed through the scrotum. As in a radical inguinal orchiectomy, a prosthetic testicle can be inserted. In both simple and radical orchiectomy, a single testicle can be removed, or both testicles, which is called bilateral orchiectomy.
. Subcapsular Orchiectomy: During a subcapsular orchiectomy, the glandular tissue lining the testicles is removed, leaving the testicles in place.
. Bilateral orchiectomy: Both testicles are removed. This may be done if you have prostate cancer, breast cancer, or are transitioning from male to female.
Your doctor may do this surgery to treat breast cancer or prostate cancer. Without the testicles, your body can’t make as much testosterone. Testosterone is a hormone that can cause prostate or breast cancer to spread more quickly. Without testosterone, the cancer may grow at a slower rate, and some symptoms, such as bone pain, may be more bearable.
Your doctor may recommend orchiectomy if you’re in generally good health, and if the cancer cells have not spread beyond your testicles or far beyond your prostate gland.
You may want to do an orchiectomy if you’re transitioning from male to female and want to reduce how much testosterone your body makes.
As with any surgery, there are risks and possible side effects. These can be:
. Reaction to anesthesia. (Anesthesia is the medication you are given to help you sleep through the surgery, not remember it and to manage pain. Reactions can include wheezing, rash, swelling and low blood pressure.)
. Blood clots.
. Loss of fertility.
. Erectile dysfunction.
. Loss of feeling in the groin and/or genitals.
. Low libido (sex drive).
. Hot flashes, mood swings, depression.
. Loss of muscle mass.
. Breast enlargement (gynecomastia).
. Weight gain.
. Change in self-image
Transgender women who undergo an orchiectomy are also likely to experience a number of positive side effects, including:
. A drastic decrease in testosterone, which may allow you to reduce your dose of feminizing hormones
. Reduced gender dysphoria as you take a step closer to matching your physical appearance with your gender identity.
Before and during procedure
To prepare for the procedure, your doctor will likely require proof that:
. You’re experiencing gender dysphoria.
. You’re able to consent to treatment and make a fully informed decision.
. You don’t have any unmanaged mental health or medical problems.
. You’ve reached the age of adulthood in the country that the procedure will take place.
Generally, a doctor will ask you to provide letters of preparedness from two different mental health professionals. You’ll also likely need to complete one year (12 consecutive months) of hormone therapy before you undergo an orchiectomy.
The procedure will take 30 to 60 minutes. Before surgery begins, your doctor will use local anesthesia to numb the area or general anesthesia to make you fall asleep so you don’t feel anything. A surgeon will then make an incision in the middle of the scrotum. They’ll remove one or both testes and then close the incision, often with sutures.
The surgery itself is an outpatient procedure. This means that if you were dropped off in the morning for the procedure, you’ll be able to leave before the end of the day.
Recovery from an orchiectomy may include a short stay in the hospital, depending on the extent of the procedure you have had. You will be taught incisional care before being discharged from the hospital.
Your medical team will discuss with you the medications you will be taking (blood clot and infection prevention, pain management, nausea management, and constipation prevention.
These dos and don’ts after surgery will help you heal:
. Keep an ice pack or cold compress on your scrotum to ease swelling. It should get better in a few days. Don't keep the ice on for more than 15 minutes at a time.
. Your surgeon probably will suggest you wear a jockstrap or snug underwear for a few days to help with swelling, too.
. Take pain medicine as prescribed. Don't drive until you've stopped taking medicine and your doctor says it's OK.
. Your doctor will tell you when you can shower. You'll have to skip baths and swimming until the cut made during surgery heals.
. The doctor will show you how to take care of your cut. Check it every day for signs of infection or other problems.
. Take it easy for a few days after surgery. Don't lift anything heavy, have sex, or do hard exercise for a few weeks. Follow the directions you get from your doctor.
. If you had surgery due to cancer, you may have to have chemotherapy or radiation to lower the chances that any leftover cancer cells will spread.