Surgical Procedures for Testicular Cancer

There are two surgical procedures done to treat testicular cancer :

Orchiectomy
Retroperitoneal lymph node dissection (RPLND)

Orchiectomy

Orchiectomy is the surgical removal of the testicle. If your examination and tests are consistent with cancer, you will probably have surgery to examine the testicle directly. An incision is made in the groin and the entire testicle is removed if it appears to have cancer.

It is possible during this procedure or in a subsequent operation to place a prosthetic (fake) testicle in the scrotum to recreate a normal appearance.

Retroperitoneal Lymph Node Dissection (RPLND)

A nonseminoma cancer may have spread beyond the testis, but is likely to be confined to the lymph nodes in the area. As a result, you may have these lymph nodes surgically removed. This procedure is called a retroperitoneal lymph node dissection (RPLND).

An incision is made along your abdomen and every lymph node from your diaphragm to your anus is inspected. Any that may have cancer are removed and sent to the lab for analysis. This is major surgery, usually taking 4-6 hours or longer.

Historically, this procedure could cause significant side effects including retrograde ejaculation (ejaculation of semen back into the bladder). More recent advances in surgical techniques, however, have made these side effects much less common, but has not eliminated them entirely.

References

Association of Cancer Online Resources website. Available at: http://www.acor.org . Accessed January 31, 2006.

Casciato DA. Manual of Clinical Oncology. 5th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2004.

Cashen AF, Wildes TM. The Washington Manual of Hematology and Oncology Subspeciality Consult. 2nd ed. Philadelphia, PA: Wolter Kluwers Health; 2008.

Columbia Presbyterian Medical Center website. Available at: http://cpmcnet.columbia.edu/ . Accessed January 31, 2006.

Fauci AS, Braunwald E, Isselbacher KJ, et al. Harrison's Principles of Internal Medicine . 14th ed. New York, NY: The McGraw-Hill Companies; 2000.

Revision Information

Reviewer: Igor Puzanov, MD
Review Date: 09/2012
Update Date: 09/20/2012

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.