Radical Orchidectomy

Why is it done?

• For testis cancer.
• For lesions highly suspicious of testis cancer.

How is it done?

• This is done under general anesthetic.

• A single incision is made in the groin. The underlying muscle layers are split for good oncological control.
• The affected testis and spermatic cord is then surgically removed through this incision.
• A metal clip may be left right at the internal inguinal ring, as a future marker, should radiotherapy be required.
• Subcutaneous sutures (which need not be removed) are used, unless stated otherwise by Dr Schoeman.
• A dressing is then applied, which should be removed after 72 hours.
• A local anesthetic is injected into the wound, thus giving post-operative pain relief for the next 4-6 hours.
• A drain may also be left for 24-48 hours to prevent the collection of serous fluids.

NB! Regular self-examination highly recommended.

What to expect after the procedure

• Any anesthetic has its risks, and the anesthetist will explain such risks.
• Bleeding is a common complication. If concerned call the hospital.
• A hematoma (blood collection under the skin) may form and needs to be reviewed by Dr Schoeman as soon as possible.
• An infection of the wound may occur and requires immediate attention.
• Owing to the nature of the surgery and the soft skin of the scrotum, bruising may appear much worse than it is and is no cause for alarm.
• DANGER SIGNS: A scrotum that swells immediately to the size of a football, fever, or puss. Contact Dr Schoeman or the hospital immediately as this occurs in up to 15 % of all cases.

What next?

• The dressing should be kept dry for the initial 72 hours after surgery.
• The dressing should then be removed in a bath. It should be soaked until it comes off with ease.
• The dressing may sometimes adhere to the wound causing slight bleeding on removal. Don’t panic, the bleeding will stop.
• On discharge a prescription may be issued for the patient to collect.
• Patients should schedule a follow-up appointment with Dr Schoeman within 2 weeks to review pathology and arrange subsequent management.
• There will be signs of bruising for at least 10 days.
• The suture-line will be hard and indurated for at least 8-10 weeks.
• Sick leave will be granted for 14 days.
• Please don’t hesitate to direct any further queries to Dr Schoeman’s rooms.
• PLEASE CONTACT THE HOSPITAL DIRECT WITH ANY POST-OPERATIVE CONCERNS AND RETURN TO THE HOSPITAL IMMEDIATELY SHOULD THERE BE ANY SIGNS OF SEPSIS.

NB! You are required to bring 2 pairs of tight new undies for post-operative scrotal support.

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Wes Orchidectomy Radical