Informed Consent for Orchidectomy (Testicle Removal) Surgery

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Informed Consent for Orchidectomy (Testicle Removal) Surgery

Patient and Provider Information

What is an Orchidectomy?

An orchidectomy (also spelled orchiectomy) is a surgical procedure to remove one or both of your testicles (testes). Testicles are the male sex glands that produce sperm and the hormone testosterone. An orchidectomy is performed to: (1) treat testicular cancer by removing a suspected tumor; (2) manage advanced prostate cancer by stopping testosterone production, which slows the growth of cancer cells; (3) treat a severely damaged or dead testicle caused by trauma or lack of blood supply (testicular torsion); or (4) align physical anatomy for gender affirmation. If only one testicle is removed (unilateral), the remaining testicle usually produces enough hormones and sperm for normal function.

How is the Surgery Performed?

The surgery is performed in an operating room under general anesthesia (so you are asleep) or spinal anesthesia (which numbs you from the waist down). The surgeon will: (1) Clean and drape the surgical area. (2) Make a small incision. For cancer cases, the incision is made in the groin (inguinal) to safely remove the testicle and its surrounding spermatic cord without spreading cancer cells. For other cases, a small incision in the scrotum may be used. (3) Dissect, clamp, and cut the blood vessels and spermatic cord, then lift the testicle out. (4) Place a silicone testicle implant (prosthesis) in the scrotum if you have requested it and discussed it preoperatively. (5) Close the tissue layers and skin incision with dissolvable stitches, and apply a supportive dressing. The surgery takes about 30 to 60 minutes.

Expected Benefits

Removal of the primary source of cancer cells in cases of suspected testicular cancer.
Rapid, permanent reduction in testosterone levels to help control and shrink advanced prostate cancer.
Elimination of pain or severe infection from a dead or severely damaged testicle.
Facilitation of physical alignment in gender-affirming medical protocols.

Risks and Potential Complications

Scrotal Hematoma and Swelling: The empty space in the scrotum can fill with blood after surgery, causing severe swelling, pain, and bruising. This usually resolves with ice and support, but may require drainage.
Infection: Risk of infection at the incision site or inside the scrotum. This is managed with wound care and antibiotics.
Hormonal Side Effects (If both testicles are removed): A complete loss of testosterone will cause changes in your body, including hot flashes, fatigue, loss of sex drive (libido), difficulty getting erections, weight gain, loss of muscle mass, and long-term risk of thin bones (osteoporosis). These are managed with hormone replacement therapy if cancer permits.
Infertility: Removing both testicles causes permanent infertility (you will not be able to father children). If one testicle is removed and the other is healthy, your fertility is usually preserved. Sperm banking should be discussed prior to surgery.
Chronic Scrotal Pain: Some patients experience ongoing, dull ache or phantom sensations in the scrotum that can persist for months after healing.
Implant Complications: If a cosmetic silicone implant is placed, risks include implant displacement, chronic pain, or infection requiring removal of the implant.

Alternatives to Orchidectomy

Medical Hormone Suppression: Taking monthly injections or daily medications to block testosterone production for prostate cancer, instead of surgical removal.
Chemotherapy or Radiation: Primary non-surgical treatments for cancer, though surgical removal of the primary tumor is almost always the standard first step.
Refusal of Treatment: Choosing not to have surgery. Testicular cancer can spread rapidly to other organs (lungs, brain, bones) and become fatal if left untreated.

Patient Acknowledgment and Authorization

I confirm that the urologist has explained why an orchidectomy is necessary (unilateral or bilateral), how it is performed, the benefits, and the risks (especially swelling, hormonal changes, and infertility). I have had the opportunity to discuss sperm banking and cosmetic implants. I understand the alternatives and the risks of refusing treatment. I voluntarily authorize the surgeon to perform this procedure.

Signatures and Verification

Patient Signature (or Legally Authorized Representative)
Relationship to Patient (if Representative)
Operating Urologist Signature
Witness Signature (Optional)
Date and Time of Consent
Document ID: CC-PENDING
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