Definition:
It is the removal of didymus, epididymis and the proximal section of the spermatic cord.
Indications:
It is performed in case of malignant testicular cancer.
Technical Description:
The access path to the scrotum sack is only inguinal.
Inguinal access in case of primitive neoplasm of the testicle. This access route avoids interruption of the scrotal lymphatics that could alter the path of any tumor metastases and also allows the spermatic cord to be removed up to the internal inguinal ring. This access path allows the intrascrotal positioning of a any prosthesis.
Preparation for intervention:
Preoperative antibiotic therapy and local trichotomy.
Duration of intervention:
30 minutes
Type and duration of hospitalization:
The intervention can be performed in local, regional or general anesthesia. Therefore, it can be done in One Day Surgery or ordinary hospitalization (to be preferred in case of concomitant diseases aggravating the risk of surgery).
Results:
Generally good
Complications:
The greatest risk of orchiectomy is the bleeding from the incised sperm cord. If such hemorrhage occurs, an exploration may be needed to drain the hematoma.
Another complication may be the infection of the wound with possible abscess formation. In this case, wound exploration is also necessary.
Lastly, the scrotal edema is to be pointed out.
Attention for the discharge of the patient:
The patient should avoid intense physical activity for at least 6 weeks. It is useful to provide the scrotum with a support (suspensory) to avoid or reduce postoperative edema. A systemic antibiotic therapy for at least 5 days is recommended.
How to behave in case of complications after discharge:
The volume increasing of the scrotum due to hematoma or abscess requires drainage.
Checks:
The type of checks and their cadence will be specified in the final discharge letter after evaluating the histological examination report.