How does losing a testicle affect sexual performance. Can you still have biological children after testicle removal. What are the psychological impacts of testicular loss on masculinity. How noticeable is the absence of one testicle. What support options are available for men who have undergone orchiectomy. Are prosthetic implants necessary after testicle removal. How does testicular cancer treatment impact overall men’s health.

The Physical and Emotional Impact of Losing a Testicle

Losing a testicle, whether due to cancer or other medical conditions, can be a challenging experience for men. It’s natural to have concerns about how this loss might affect various aspects of life, including sexual function, fertility, and self-image. Understanding the potential effects and available support can help in navigating this difficult journey.

Sexual Performance and Testosterone Production

A common concern among men facing testicular loss is its impact on sexual performance. Will losing one testicle affect libido or erectile function? Fortunately, in most cases, the remaining testicle compensates for the lost one. According to Cancer Research UK, the surviving testicle typically increases its production of testosterone and sperm to maintain normal levels. This means that for many men, sexual performance and drive remain largely unaffected.

However, some men may experience a temporary decrease in libido. In such cases, testosterone hormone replacement therapy can be an effective solution. The Testicular Cancer Awareness Foundation notes that if low testosterone is diagnosed, replacement treatment can begin promptly, helping to restore normal sexual function and desire.

Fertility Concerns

Another crucial question for many men is whether they can still father children after losing a testicle. Is biological fatherhood still possible? The good news is that fertility is usually preserved. With one functioning testicle, sperm production often remains sufficient for conception. However, it’s important to discuss fertility preservation options with your healthcare provider, especially if you’re undergoing cancer treatment that might affect the remaining testicle.

Aesthetic Considerations and Prosthetic Options

The physical appearance of the scrotum after testicle removal is a common concern. How noticeable is the absence of one testicle? Many men who have undergone orchiectomy report that the difference is often not readily apparent to others. The scrotum’s natural elasticity can help maintain a relatively symmetrical appearance.

Prosthetic Implants: A Personal Choice

For those concerned about aesthetics, prosthetic implants are an option. Are prosthetic testicles necessary after orchiectomy? The decision is highly personal. Some men feel that a prosthetic helps them feel more “complete” or confident, while others find it unnecessary. A research study cited by Healthtalk found that approximately 75% of men who opted for a prosthetic implant were satisfied with the results.

When considering a prosthetic, it’s crucial to discuss the pros and cons with your healthcare team and partner. Factors to consider include the surgical procedure for implantation, potential complications, and personal comfort levels.

Psychological Impact and Coping Strategies

The emotional toll of losing a testicle can be significant. Many men associate their testicles with masculinity and sexuality, making the loss feel like a threat to their identity. How can one cope with these feelings?

Redefining Masculinity

It’s important to recognize that masculinity is multifaceted and not solely defined by physical attributes. Take time to reflect on what being a man means to you. This might include qualities like integrity, courage, emotional strength, or being a supportive partner or father. Discussing these aspects with a trusted friend, partner, or therapist can help broaden your perspective on masculinity.

Communication with Partners

Open communication with romantic partners is crucial. Many men worry about how their partner will view them after testicle removal. However, partners are often more concerned about overall health and well-being rather than physical changes. Honest conversations can help alleviate fears and strengthen relationships during this challenging time.

Support Systems and Resources for Men Facing Testicular Loss

Coping with testicular loss doesn’t have to be a solitary journey. What support options are available for men in this situation? Several organizations offer valuable resources:

• The American Cancer Society provides online support communities where individuals can share experiences and advice.
• CancerCare offers counseling services and support groups specifically for those affected by testicular cancer and its treatments.
• The Testicular Cancer Society provides educational resources and peer support programs.

These platforms allow men to connect with others who have gone through similar experiences, offering reassurance and practical advice.

Professional Counseling

For those struggling with body image or identity issues following testicle removal, professional counseling can be invaluable. A therapist experienced in men’s health issues can provide strategies for coping with emotional challenges and rebuilding self-confidence.

Medical Considerations in Testicular Cancer Treatment

When testicular loss is due to cancer, understanding the treatment process is crucial. What are the primary medical interventions for testicular cancer?

Radical Inguinal Orchiectomy

The primary surgical treatment for testicular cancer is radical inguinal orchiectomy. This procedure involves removing the affected testicle and the spermatic cord through an incision in the groin area. This approach helps prevent the potential spread of cancer cells through blood and lymph vessels.

Additional Treatments

Depending on the cancer type and stage, additional treatments may be necessary. These can include:

1. Chemotherapy to target cancer cells throughout the body
2. Radiation therapy for certain types of testicular cancer
3. Retroperitoneal lymph node dissection (RPLND) to remove potentially affected lymph nodes

Each treatment option carries its own set of considerations and potential side effects, which should be thoroughly discussed with the healthcare team.

Long-term Health Considerations After Testicle Removal

While the immediate concerns of testicular loss often focus on sexual function and self-image, it’s important to consider long-term health implications. What ongoing health considerations should men be aware of after orchiectomy?

Hormonal Monitoring

Regular monitoring of hormone levels, particularly testosterone, is crucial. Even if the remaining testicle compensates initially, some men may experience hormonal changes over time. Annual check-ups should include hormone level assessments to ensure optimal health.

Cancer Surveillance

For those who have had testicular cancer, ongoing surveillance is essential. This typically involves regular physical exams, blood tests, and imaging studies to detect any potential recurrence early. The frequency and duration of follow-up care will depend on the individual case and should be discussed with the oncology team.

Embracing Life After Testicular Loss

While losing a testicle can be a significant life event, it doesn’t define a man’s worth or future. Many men go on to lead fulfilling lives, maintaining satisfying relationships and pursuing their goals. How can one move forward positively after this experience?

Focusing on Overall Health

Use this experience as a catalyst for prioritizing overall health. This might include adopting a balanced diet, regular exercise, stress management techniques, and routine health check-ups. Taking control of your health can be empowering and contribute to a sense of well-being.

Advocacy and Education

Some men find purpose in becoming advocates for testicular health awareness. Sharing your story (if you’re comfortable) can help educate others about the importance of self-exams and early detection. This can be a powerful way to turn a challenging experience into a positive force for change.

Remember, coping with testicular loss is a journey that looks different for everyone. It’s okay to have ups and downs, and seeking support when needed is a sign of strength, not weakness. With time, understanding, and the right support, many men find that they can adapt to this change and continue to lead rich, fulfilling lives.

How to Cope with Losing a Testicle

Losing a testicle or having prostate cancer can take a toll on a man’s ego. You may feel that testicles represent your masculinity and sexuality. It’s normal when you lose a testicle to worry about how others might view you or to feel concerned about how it will change your sex life.

Before looking at some ways to best approach these legitimate feelings, it’s helpful to look at how losing a testicle can affect you.

Sexual Performance

Since the testicles produce sperm and testosterone, it’s understandable to worry that losing one will change your sexual drive or performance. It shouldn’t. Usually, the surviving testicle makes up for the testosterone and sperm loss, according to Cancer Research UK. Your ability to have biological children in the future should also not be affected. There’s sometimes short-term libido loss, but testosterone hormone replacement is a potential option. If you’re diagnosed with low testosterone, replacement treatment can start right away, according to the Testicular Cancer Awareness Foundation.

How It Looks

You may be concerned that losing a testicle will make your genitals look abnormal. Many men who have lost a testicle say that it’s not noticeable to others. Explore online forums, such as at TC-Cancer, to get a sense of what others in your situation feel.

Some men get prosthetic implants but others find they aren’t necessary to feel whole. Those who choose to get a prosthetic implant often want their genitals to look complete. According to Healthtalk, a research study showed that about 75% of men who got a false testicle were satisfied with the results. It all depends on what’s right for you so work with your treatment team and talk to your partner about your concerns and options.

Finding Support

The idea of losing a testicle is something to cope with and process. Losing any body part is difficult but one that helps identify you with being a man can pack more of a punch. While some men may feel comfortable chatting with friends about their concerns, you might prefer to talk with those who are going through something similar, or even better, hearing from someone who already lost a testicle. Talk to your therapist specifically about your masculinity concerns.

The American Cancer Society has several online support communities for those going through cancer treatment to share their stories and thoughts, as does CancerCare and the Testicular Cancer Society. Finding out about other mens’ experiences can be reassuring. If you have a partner, talk to them about how he or she feels about your specific situation. Most likely they are more concerned with your health and love than a missing testicle.

Losing Your Manhood

There’s more to being a man than having testicles. Spend time thinking about what makes you a man. That could be characteristics like kindness, moral integrity, and dependability. Maybe it’s having facial or body hair. For each person, the definition will be different. Also, ask your partner the same question. It can help you see that being a man is multidimensional

If you’re being treated for cancer or lose your testicle to other conditions, talk to your doctor about how it will affect you.

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Surgery for Testicular Cancer | Orchiectomy

Surgery is the first treatment for nearly all testicular cancers .

Radical inguinal orchiectomy

Surgery to remove a testicle with cancer is called a radical inguinal orchiectomy. An incision (cut) is made just above the pubic area, and the testicle is gently removed from the scrotum through the opening. The surgeon then removes the entire tumor along with the testicle and spermatic cord. The spermatic cord contains part of the vas deferens, as well as blood and lymph vessels that could act as pathways for testicular cancer to spread to the rest of the body. To lessen the chance of this, these vessels are tied off early in the operation.

All testicular cancers are typically treated with this surgery, even those that have spread.

Retroperitoneal lymph node dissection (RPLND)

Depending on the type and stage of your cancer, lymph nodes around the large blood vessels (the aorta and inferior vena cava) at the back of the abdomen (belly) may be removed at the same time as the orchiectomy or during a second operation. Not all people with testicular cancer need to have lymph nodes removed, so it’s important to discuss this (and options to it) with your doctor.

This is a complex and long operation. In most cases, a large incision (cut) is made down the middle of the abdomen to remove the lymph nodes. RPLND should be done by a surgeon who does this often. Experience counts.

Laparoscopic surgery

In some cases, the surgeon can remove lymph nodes through very small skin incisions in the abdomen by using a laparoscope and other long, thin surgical tools. A laparoscope is a narrow, lighted tube with a small camera on the end that lets doctors see inside the abdomen. The surgeon’s hands are not inside the patient’s body during this type of surgery.

In laparoscopic surgery, after being put to sleep, you’re turned onto your side. Several small incisions are made on your abdomen. The laparoscope and surgical tools are put in through the incisions to remove the lymph nodes. The incisions are then closed and you’re woken up.

Patients recover much more quickly from this operation than the standard open procedure and are walking soon after surgery. There’s usually less pain and patients are eating sooner.

Laparoscopic surgery seems to be a lot easier for the patient, but doctors aren’t sure if it’s as safe and effective as the standard “open” surgery in removing all of the lymph nodes that may contain cancer. Because of this uncertainty, doctors are more likely to recommend chemotherapy after laparoscopic surgery if cancer is found in the lymph nodes.

This procedure is most often used for patients with early-stage non-seminomas to see if the lymph nodes contain cancer. As with the standard open procedure, this is a complex operation that should only be done if the surgeon is very experienced.

Possible risks and side effects of surgery

The short-term risks of any type of surgery include reactions to anesthesia, excess bleeding, blood clots, and infections. Most men will have at least some pain after the operation, which can be helped with pain medicines, if needed.

Effects of orchiectomy

Losing one testicle usually has no effect on a man’s ability to get an erection and have sex. But if both testicles are removed, sperm cannot be made and a man becomes infertile. Also, without testicles, a man cannot make enough testosterone, which can decrease sex drive and affect his ability to have erections. Other effects could include fatigue, hot flashes, and loss of muscle mass. These side effects can be avoided by taking testosterone supplements, either in a gel, a patch, or a shot. Pills are generally not reliable sources of testosterone.

Usually men with testicular cancer are young and may be concerned about changes in how they look. They may be dating and worry about a partner’s reaction, or they may be athletic and feel embarrassed by the missing testicle when in locker rooms.

To restore a more natural look, a man can have a testicular prosthesis surgically implanted in his scrotum. The prosthesis approved for use in the United States is filled with saline (salt water) and comes in different sizes to match the remaining testicle. When in place, it can look like a normal testicle. There can be a scar after the operation, but it’s often partly hidden by pubic hair. Some men might want a prosthesis, while others might not. You should discuss your wishes with your surgeon before surgery. It could also help to talk with someone who has a testicular prosthesis, to hear what it has been like for them.

Effects of lymph node dissection

Surgery to remove retroperitoneal lymph nodes is a major operation. Serious complications are not common, but they can happen. About 5% to 10% of patients have short-term problems after surgery, such as infection or bowel obstruction (blockage). The standard approach for an RPLND requires a large incision in the abdomen, which will leave a scar and can take some time to heal. Your ability to get up and around after the operation will be limited for some time. This is less likely to be an issue if you have laparoscopic surgery, which uses smaller incisions.

This type of surgery does not cause impotence – a man can still have erections and sex. But it might damage some of the nerves that control ejaculation. If these nerves are damaged, when a man ejaculates, the semen doesn’t come out through the urethra to exit the body but rather goes backwards into the bladder. This is called retrograde ejaculation, and it can make it hard to father children.

To save the normal ejaculation function, surgeons have developed a type of retroperitoneal lymph node surgery called nerve-sparing surgery that’s very successful when done by experienced doctors. Testicular cancer often affects men at an age when they might be trying to have children. These men may wish to discuss nerve-sparing surgery with their doctors, as well as sperm banking (freezing and storing sperm cells obtained before treatment). Men with testicular cancer often have lower than normal sperm counts, which can sometimes make it hard to collect a good sperm sample. See Fertility and Men With Cancer for more about this.

Orchiectomy: indications, how to perform, fertility

Orchiectomy is a surgical procedure during which a testicle is removed from a man. It is unilateral, when only one testicle is removed, and bilateral, when both are removed. Most often, this operation is used for malignant tumors. The operation lasts up to an hour and a half, it can be performed under anesthesia or local anesthesia. An incision is made on the skin of the scrotum or in the groin area. An outpatient operation is possible, when a man is not hospitalized in a hospital, he can return home on the same day.

Our expert in this area:

Dmitriev Sergey Viktorovich

Urologist, PhD, doctor of the highest category

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The international clinic Medica24 employs experienced andrologist surgeons who are fluent in the technique of orchiectomy, performing it in an operating room equipped with modern equipment. Sign up for a consultation with our doctor – he will carefully assess your situation, prescribe the necessary examination and evaluate the indications for orchiectomy in your case.

When is an orchiectomy indicated?

The most common indication is testicular cancer. They are quite rare and account for less than 0.5% of all cancers in men. In Russia, more than a thousand new cases are registered annually. Usually, if a testicular malignancy is suspected, it is immediately removed entirely. A biopsy is not performed before surgery because it can lead to the spread of cancer cells. Ultrasound of the scrotum and a blood test for tumor markers make it possible to establish an oncological diagnosis with high accuracy and make a decision on the need for surgical intervention.

For malignant testicular tumors, a radical inguinal orchiectomy is performed. The incision is made in the groin, because along with the testicle, the spermatic cord must be removed by cutting it as high as possible. In the spermatic cord are blood and lymphatic vessels, which can serve as pathways for the spread of tumor cells.

Also in oncology, bilateral orchiectomy is used in some cases for malignant tumors of the prostate and breast cancer in men. In this case, the purpose of the operation is surgical castration. The testicles produce most of the male sex hormones – androgens. After their removal, the hormone-sensitive tumor stops growing or decreases in size. Orchiectomy is the easiest way to stop tumor growth under the influence of hormones, but there are other methods with the use of medications.

Other indications for testicle removal:

• Necrotizing orchitis, epididymitis is an inflammatory process in the testicle and its epididymis, accompanied by tissue death. Most often, this pathology occurs with torsion.
• Severe testicular injury: its crushing, detachment of the spermatic cord.
• Severe testicular atrophy – its reduction in size, usually with varicocele (testicular varicose veins) or cryptorchidism (undescended testicle into the scrotum).
• Severe testicular infections.
• Transgender, when a man feels like a woman and wants to change his gender. In such cases, the doctor must carefully examine the patient’s motives, make sure that he does not suffer from mental disorders, and he really needs such an operation.

Orchiectomy contraindications

• malignant testicular tumors with multiple metastases;
• severe violations of the function of the kidneys, liver;
• significant reduction in blood clotting;
• ischemic heart disease, recent myocardial infarction;
• severe pathologies of the lungs, accompanied by respiratory failure of 2-3 degrees;
• conditions in which other methods of treatment can be dispensed with and not remove the testicle.

Orchiectomy should only be used when it is the only possible and objectively necessary treatment. Contact a doctor at Medica24 International Clinic and he will decide whether such an operation is required in your case.

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Preparing for surgery

constantly taking any medications, whether he suffers from bad habits. Some medications may be temporarily discontinued, for example, anticoagulants (which reduce blood clotting), non-steroidal anti-inflammatory drugs. It is recommended to stop drinking alcohol and quit smoking a few weeks before surgery. This will help to better transfer the operation, reduce the risk of some complications.

You need to undergo a preoperative examination, which includes blood and urine tests, blood clotting assessment, determination of the AB0 group and Rh factor, tests for infections (HIV, viral hepatitis, syphilis), ECG, fluorography, consultation with a therapist.

If the orchiectomy is to be performed under general anesthesia, do not eat or drink anything 10-12 hours before the operation.

An anesthesiologist also talks to the patient in advance, learns about concomitant diseases, allergic reactions, and assesses the risks associated with anesthesia.

How is an orchiectomy performed?

During inguinal access, a 5–10 cm incision is made in the groin. The surgeon exposes the spermatic cord, removes the testicle from the scrotum and releases it from the surrounding tissues. When the testis is isolated, the spermatic cord is ligated and transected. In cancer, this should be done as close as possible to the external inguinal ring in order to remove as much of the spermatic cord as possible. Tissue plastic surgery is performed to prevent the formation of an inguinal hernia in the future, after which the incision is sutured.

For orchiectomy through the scrotum, the incision is made along the scrotal suture. The testicle is brought out into the wound, freed from the surrounding tissues. Then they pinch, bandage and cross the spermatic cord. Its remaining end is immersed in the scrotum and sutured.

If necessary, all the same manipulations are repeated with the second testicle.

Recovery period

After removal of the testicle, swelling of the scrotum persists for some time and may cause pain. To combat swelling, cold compresses are used – they need to be kept for no more than 15 minutes. Your doctor may recommend wearing compression or tight-fitting underwear. Non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, are used to relieve pain.

It is necessary to refrain from taking baths and visiting pools until the tissues at the incision site have completely healed. You can take a shower with the permission of the attending physician. Stitches are usually removed after 7-10 days. For several weeks, intense physical activity and sex are prohibited. You can get behind the wheel after you have finished taking painkillers.

Treatment and follow-up after orchiectomy for malignant testicular tumors

If the testicle was removed due to a malignant tumor, then the patient may need additional treatment.

Seminomas in the early stages (I, IIA, IIB) are treated with radiation therapy, and in later stages (IIB, IIC, III) – chemotherapy. After treatment, the doctor prescribes examinations, chest x-rays and blood tests for tumor markers every 2 months during the first year and every 3 months during the second year. Every 4 months for the first two years and every 6 months for at least five subsequent years, a CT scan is performed. Regular follow-up examinations help to detect a relapse in a timely manner and immediately begin treatment.

For nonseminoma testicular tumors, follow-up includes doctor’s examinations, blood tests for tumor markers and chest x-ray once a month during the first year, once every two months – during the second year. Computed tomography is performed every 3 months for the first two years and every 6 months for five years.

The international clinic Medica24 provides comprehensive treatment for testicular cancer and other malignant tumors. We use all modern types of diagnostics, the latest anticancer drugs, patients are consulted by leading doctors.

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Possible complications, consequences of orchiectomy

Like any surgical intervention, orchiectomy is accompanied by the risk of bleeding, infection, complications associated with general anesthesia. Thanks to the modern equipment of operating rooms and the high professionalism of surgeons, in the international clinic Medica24 the likelihood of such negative consequences is reduced to almost zero.

After a bilateral orchiectomy, complications such as:

• Infertility: the man no longer has testicles, therefore, spermatozoa are not produced in his body.
• Decreased libido and erection problems due to a sharp drop in androgen levels in the body.
• Metabolic disorder, which manifests itself as an increase in body weight, loss of muscle mass, enlargement of the mammary glands (gynecomastia), hot flashes. The risk of developing osteoporosis increases.

Orchiectomy and male fertility

After a unilateral orchiectomy, the remaining testicle continues to produce spermatozoa and male sex hormones. Therefore, a man, as a rule, retains fertility and may have children in the future.

Bilateral orchiectomy always results in infertility. This problem cannot be solved with the help of IVF and other assisted reproductive technologies, because spermatozoa cease to be produced in the body of a man. However, your doctor may suggest some solutions:

• Before surgery , semen can be collected and stored in a cryobank. Subsequently, it can be used for in vitro fertilization.
• If your own sperm has not been saved, you can use a donor. In this case, the man will not be the biological father of the child, but you can choose a donor who is as similar as possible to him. Also, a close relative can act as a donor.

Testicular prosthesis

After the removal of the testicles, many men experience psychological problems: complexes develop, self-esteem and self-confidence decrease, and sexual life is disturbed. Therefore, in accordance with modern approaches, doctors should offer testicular prosthetics to all patients after orchiectomy. It is important to understand: the prosthesis will not produce spermatozoa and hormones, it has an exclusively cosmetic function.

Correction of erectile dysfunction and metabolic disorders

To cope with problems caused by a decrease in the level of male sex hormones, the doctor may prescribe hormone replacement therapy after an orchiectomy.

At the Medica24 International Clinic, you can always get a detailed consultation from a doctor and undergo treatment in accordance with modern international standards. An andrologist surgeon will determine whether orchiectomy is necessary in your case, perform the surgical intervention skillfully and with minimal risks, and take all necessary measures to ensure a high quality of life after the operation.

The material was prepared by a urologist, candidate of medical sciences, doctor of the highest category of the international clinic Medica24 Sergey Viktorovich Dmitriev.

Change in the shape of the testis.

Reasons and what to do

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• Men! Note! Change in the shape of the testicle. Reasons and what to do?

Recently, the number of patients with complaints of a change in the shape of the testicle has increased. Let’s look at this issue in more detail. A little anatomy. In the scrotum there are testicles with appendages, vas deferens and blood vessels – the arteries through which God passes…

Recently, the number of patients with complaints of changes in the shape of the testicle has increased. Let’s look at this issue in more detail.

A bit of anatomy. In the scrotum there are testicles with appendages, vas deferens and vessels – arteries through which oxygen-rich and nutrient-rich blood flows to the organ, and veins through which blood moves in the opposite direction.

All pathological conditions can be conditionally divided into two groups: inflammatory and non-inflammatory.

Inflammatory diseases of the testis and its appendages are always accompanied by pain, fever, increase in the volume and density of the affected organ, and possible enlargement and soreness of regional lymph nodes. In this case, urgently consult a doctor, as a delay in the appointment of rational therapy threatens with the loss of an organ.

If you, dear men, have found some changes while probing the scrotum, and at the same time there are no pain sensations, this may not alert you right away, and the pathological process will develop in the meantime.

We always consider oncopathology to be the most serious, and, unfortunately, it also often affects the testicle, and besides, this pathology is most often found in men aged 25-40. What symptoms should alert a man and make him see a urologist?

First of all, this is the appearance of an additional solid painless formation of the testicle, while the organ increases unevenly, becomes asymmetric.

Diagnosis of testicular diseases includes a consultation with a urologist, ultrasound of the scrotum (with or without Doppler, depending on the purpose of the study), and, if necessary, additional biochemical blood tests.

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