Radical orchiectomy is a surgical procedure done to remove a testicle and the spermatic cord through an incision in the lower abdomen. This surgery is the procedure of choice if testicular cancer is suspected. Most commonly, it is performed as a same-day surgery with the patient returning home within hours of the operation.
While it is possible to remove a testicle through an incision in the scrotum, this is not done when cancer is suspected because this will disrupt the natural lymphatic drainage. Because testicular cancer usually spreads through these natural drainage patterns, an incision in the scrotum will disrupt the predictability of spread and make surveillance and future surgeries more difficult.
To remove the testicle, an incision is made in the groin of the side with the testicular mass. The entire testicle and spermatic cord (contains the arteries, veins, lymphatics, and connective tissue) are removed. The incision is typically closed with dissolving suture or with staples that are removed a week or ten days later in the office. For cosmetic reasons, some patients elect to have a prosthetic, saline-filled testicle inserted in the scrotum. A general or spinal anesthetic is necessary for this surgery. Risks of this surgery generally include pain, bleeding, infection, and rarely numbness.