Orchiectomy Recovery Time: A Complete Guide to Healing

What to Expect After an Orchiectomy

An orchiectomy is a surgery to remove one or both of your testicles. The most common reason for this surgery is testicular cancer. However, it’s also performed as part of gender affirmation surgery, including FTM bottom surgery, and to treat advanced prostate cancer.

Knowing what to expect after your surgery can ease anxiety and help you follow your doctor’s instructions.

The orchiectomy recovery time varies from person to person, but this article will walk you through what to expect. We’ll discuss what to do before surgery, what happens right after, potential problems, and what you need to consider for the long term.

Understanding Orchiectomy: Types and Reasons

An orchiectomy is a surgical procedure that involves removing one or both testicles. There are different types of orchiectomies, and the reasons for the procedure can vary.

Types of Orchiectomy

• Radical Orchiectomy: This involves removing the entire testicle and spermatic cord. It’s typically performed when testicular cancer is suspected.
• Simple Orchiectomy: This involves removing only the testicle. It’s often done for non-cancerous conditions or as part of gender affirmation surgery.
• Bilateral Orchiectomy: This involves removing both testicles.

Reasons for Orchiectomy

An orchiectomy may be recommended for a number of reasons:

• Testicular Cancer: A radical orchiectomy is the most common treatment for testicular cancer. The surgery helps diagnose and stage the cancer.
• Gender Affirmation Surgery: Orchiectomy can be part of gender-affirming care for transgender women.
• Advanced Prostate Cancer: Removing the testicles can reduce testosterone levels, which can help manage advanced prostate cancer.
• Other conditions: Orchiectomy may be necessary in cases of testicular torsion, infection, or trauma.

Pre-Operative Preparation: Getting Ready for Surgery

Preparing for an orchiectomy involves several important steps to ensure the best possible outcome. Your doctor will give you detailed instructions, but here’s a general overview:

Medical Evaluation and Presurgical Testing (PST)

You’ll undergo a thorough medical history review and physical examination. Your doctor will likely order blood tests, an EKG, and other necessary tests to assess your overall health. It’s crucial to discuss all medications and supplements you’re taking with your healthcare provider, including over-the-counter items. Be honest and upfront about everything.

Lifestyle Modifications

Making certain lifestyle changes can significantly impact your recovery.

• Smoking cessation: If you smoke or use electronic smoking devices, now is the time to stop.
• Alcohol consumption: Be honest with your doctor about your alcohol consumption, and stop drinking once surgery is scheduled. It’s important to address any potential alcohol withdrawal issues.
• Sleep apnea: If you have sleep apnea, be sure to bring your breathing device with you to the hospital.

Medication Adjustments

Your doctor will provide specific instructions regarding your medications. Here are some common guidelines:

• Aspirin: Follow your healthcare provider’s instructions carefully for taking aspirin.
• Vitamin E, multivitamins, herbal remedies, and other dietary supplements: Stop taking these 7 days before surgery.
• Nonsteroidal anti-inflammatory drugs (NSAIDs): Stop taking NSAIDs 2 days before surgery.

Practical Preparations

There are also practical steps you can take to prepare for your recovery:

• Arrange for a caregiver: Having a caregiver can provide invaluable support during your recovery.
• Fill out a Health Care Proxy form: This form designates someone to make medical decisions on your behalf if you are unable to do so.
• Sperm banking: If fertility is a concern, consider sperm banking before the surgery.

The Day of Surgery: What to Expect

The day of your orchiectomy, it’s important to follow your medical team’s instructions closely. Here’s a rundown of what you can likely expect:

• Pre-operative Shower: You’ll be asked to shower with a special antiseptic cleanser (usually a 4% CHG solution). This helps reduce the risk of infection.
• Fasting: Make sure you stick to the eating and drinking guidelines your healthcare team gave you. An empty stomach is usually required for anesthesia.
• Medication: Take any medications as directed by your doctor. Don’t deviate from the plan.
• Hospital Arrival: When you arrive at the hospital, bring only what’s essential. You’ll meet with a nurse who will go over your information and prepare you for surgery. You’ll also meet with the anesthesiologist to discuss the anesthesia plan.

Immediate Post-Operative Period: The First Few Days

The first few days after an orchiectomy are focused on managing pain and ensuring a smooth start to your recovery. Here’s what you can typically expect:

In the Hospital

Immediately after surgery, you’ll be monitored closely. Hospital staff will check your vital signs like heart rate, blood pressure, and breathing. They’ll also focus on managing your pain. You’ll likely receive IV fluids and medications to keep you comfortable.

Before you’re discharged, the medical team will give you detailed instructions on how to care for your surgical wound at home. They’ll explain how to clean the area, what signs of infection to watch out for, and when to schedule a follow-up appointment.

Pain Management

Managing pain is crucial for a comfortable recovery. Your doctor will prescribe pain medication, which may include opioids, NSAIDs (non-steroidal anti-inflammatory drugs), or local anesthetics. Opioids are stronger pain relievers, while NSAIDs help reduce inflammation and milder pain. Local anesthetics can numb the area around the incision.

It’s important to take your pain medication as prescribed and to keep track of when you take each dose. This helps you stay ahead of the pain and ensures that the medication is working effectively.

Preventing and Managing Constipation

A common side effect of opioid pain medications is constipation. To prevent this, it’s important to increase your fluid intake and eat a fiber-rich diet. You may also want to ask your doctor about using a stool softener.

Dietary recommendations include aiming for 25 to 35 grams of fiber per day. Good sources of fiber include fruits, vegetables, whole grains, and legumes.

Early Ambulation

Getting up and moving around as soon as possible after surgery is important for preventing blood clots and promoting healing. Even short walks around your room can make a big difference.

Your medical team will encourage you to start moving around as soon as you’re able. This helps improve circulation, reduces the risk of complications, and speeds up your recovery.

Short-Term Recovery: Weeks 1-4

The first month after an orchiectomy is crucial for healing and getting back on your feet. Here’s a breakdown of what to expect:

Wound Care

Keeping your incision clean and dry is paramount to prevent infection. Your doctor will give you specific instructions, but here are some general guidelines:

• You’ll usually be able to shower about 24-48 hours after surgery.
• Gently wash the area with mild soap and water, then pat it dry with a clean towel. Avoid scrubbing.
• Watch for signs of infection, such as increased pain, redness, swelling, drainage from the incision, or a fever. A temperature of 100.5°F (38°C) or higher should be reported to your doctor immediately.

Activity Restrictions

In the initial weeks, it’s essential to take it easy. This means:

• Avoiding strenuous activities like running, heavy lifting, or intense exercise. Limit lifting to no more than 10 pounds (4.5 kilograms).
• Gradually increasing your activity level as you feel better. Don’t push yourself too hard, and listen to your body. If you experience pain, rest.

Returning to Work

When you can go back to work depends on the type of work you do and how your recovery is progressing. If you have a desk job, you might be able to return sooner than someone who does manual labor. Most people can get back to normal activities in about 2 weeks, but this can vary. Talk to your doctor about your specific situation.

Managing Discomfort

It’s common to experience some discomfort in the groin and scrotum area for about a week or so after surgery. Your doctor will likely prescribe pain medication to help manage this. Dissolvable stitches are often used, and these typically dissolve within 3 to 4 weeks.

Diet and Hydration

A healthy diet and adequate hydration are crucial for promoting healing. Aim for:

• A balanced diet rich in fruits, vegetables, lean protein, and whole grains.
• Drinking 8 to 10 (8-ounce) cups (2 liters) of water per day to stay hydrated.

Potential Complications and How to Manage Them

Like any surgery, an orchiectomy comes with potential complications. While serious problems are rare, it’s important to be aware of what to look for and how to handle them.

Infection

Keep a close eye on your incision site. Signs of infection include:

• Fever
• Increased pain
• Redness
• Swelling
• Drainage from the incision

If you notice any of these, contact your doctor right away. Infections are usually treated with antibiotics.

Bleeding and Hematoma

A small amount of bleeding from the incision is normal in the first few days. However, a hematoma – a collection of blood under the skin – can also occur.

To manage this, apply ice packs to the area as directed by your doctor. It’s important to monitor the site closely. If you have concerns about pain, bleeding, or signs of infection, don’t hesitate to contact your specialist nurse or the hospital advice line.

Pain and Discomfort

Some pain is expected after surgery, but persistent pain despite medication should be addressed. Some men also experience phantom pain, a sensation of pain in the testicle that was removed. This is a real phenomenon and can be managed. Talk to your doctor about alternative pain management techniques, such as acupuncture or physical therapy.

Lymphedema

In rare cases, lymphedema, or swelling in the legs or groin due to lymphatic fluid buildup, can occur. If you experience this, your doctor may recommend compression garments and/or physical therapy to help manage the swelling.

Long-Term Considerations: Sex, Fertility, and Hormone Replacement

Undergoing an orchiectomy can have lasting effects that extend beyond the initial recovery period. It’s important to be aware of these potential long-term considerations and discuss them with your healthcare team.

Impact on Sex and Fertility

An orchiectomy, particularly when both testicles are removed (bilateral orchiectomy), can significantly impact fertility. If preserving fertility is a concern, sperm banking before the procedure should be considered.

Your doctor can give you the go-ahead for when it’s safe to resume sexual activity after the wound has healed and you’re feeling up to it.

Testosterone Replacement Therapy (TRT)

After a bilateral orchiectomy, testosterone replacement therapy (TRT) becomes necessary to maintain normal testosterone levels. TRT can help improve energy levels, mood, and sexual function.

TRT is available in various forms, including injections, patches, and gels. Talk to your doctor about which method is best for you.

Prosthesis (False Testicle)

For some, the change in physical appearance after an orchiectomy can be difficult. A testicular prosthesis, or false testicle, can be surgically implanted for cosmetic reasons. Discuss this option with your surgeon if it’s something you’re considering.

Emotional and Psychological Support

It’s essential to acknowledge that an orchiectomy can have a significant emotional and psychological impact. Many people experience feelings of anxiety, depression, or changes in body image. Seeking support from family, friends, or a therapist can be incredibly helpful during this time. Don’t hesitate to reach out for professional help if you’re struggling to cope.

Frequently Asked Questions

In Conclusion

Preparing for your orchiectomy is important, but so is taking care of yourself after the procedure. Following your healthcare team’s instructions for wound care, pain management, and activity restrictions is key to a smooth recovery. And don’t hesitate to contact them if you notice anything unusual or have any questions.

You play a big role in your recovery. Be an active participant by:

• attending all follow-up appointments
• taking medications as prescribed
• monitoring your incision for signs of infection

Consider using tools like MSK MyChart to stay organized and communicate with your care team. You can use it to track your medications, review instructions, and send messages to your doctors and nurses.

Remember, recovery takes time, and everyone heals at their own pace. By taking an active role in your care, communicating openly with your healthcare team, and prioritizing your well-being, you can achieve a successful recovery and maintain your long-term health.