What to Know About Surgery for Testicular Cancer

Surgery is often the first choice for treating testicular cancer.

Surgery is usually the first treatment for testicular cancer. This is usually followed by either radiation or chemotherapy. If the surgeon can remove all of your cancer, you may not need other treatments.

Preparing for Testicular Surgery

An urologist will perform your surgery for testicular cancer. You meet with your surgeon beforehand to talk about what to expect. Be ready to ask any questions and address any concerns you may have about the surgery during this meeting. Be sure to ask any questions you have about the anesthesia. Ask your doctor what side effects you may have after surgery. Talk about the risks of the surgery. Ask your doctor what your recovery will be like and when you can return to your normal activities.

If you wish to have children in the future, you should talk to your doctor about how the surgery could affect your fertility. Many men decide to preserve a sample of their sperm before treatment for testicular cancer. This is called sperm banking. If the treatment makes you infertile, you and your partner could use this sperm to conceive a child. Discuss this option with your doctor if it is a concern.

What Happens During Surgery for Testicular Cancer

Before surgery, you’ll be given anesthesia so you will fall asleep and not feel any pain. The anesthesiologist or a nurse anesthetist will meet with you before your surgery. The anesthesia specialist will ask you about your medical history, and will tell you how the anesthesia will affect you.

Your surgeon performs your surgery in an operating room. You may stay in the hospital for a few days after your operation.

The surgery for testicular cancer is called a radical inguinal orchiectomy. The surgeon makes a cut in your groin and takes out your testicle through the inguinal canal. The surgeon cuts the spermatic cord. This cord connects the testicle to your abdomen. Your surgeon removes your testicle along with the tumor. If you have cancer in both of your testicles, the surgeon removes them both. If your doctor removes both of your testicles, you will no longer be able to make sperm, so you will be infertile.

If you have cancer in both of your testicles, your doctor will remove them both. Your surgeon will not remove your scrotum. If you wish, you can have your doctor insert an artificial testicle at a later time. Some lymph nodes may also be removed during your surgery. Or your doctor may remove them during a second surgery.

Depending on the stage of the cancer, the surgeon may also take out lymph nodes behind the abdomen. This is called a retroperitoneal lymph node dissection (RPLND).You may have it done at the same time the tumor is removed, or in a separate surgery afterwards. An RPLND is a very difficult surgery, and must be done by a skilled surgeon.