A partial orchiectomy is testis sparing surgery for testicular cancer. Before undergoing testis-sparing surgery, an extensive consultation should occur with the patient and their family regarding expectations and possible outcomes in the operating room.
Once the testicle has been accessed, the testis-sparing portion should begin. Intraoperative ultrasound should be used to identify the mass, rule out other masses and create a full surgical plan. The outer layer of the testicle (the tunica albuginea, which houses the tubules of the testicle) is opened and the mass is removed. Often a small surrounding area of normal testicular tissue is taken as well. The mass will go to pathology for frozen analysis — an expert genitourinary pathologist should evaluate the mass when possible.
If the patient has a normal contralateral testicle and cancer is confirmed in the mass, a completion radical orchiectomy should be performed. If the patient has (or had) cancer in the contralateral testicle, the pathologist should confirm negative margins before leaving the remainder of the testicle. If there is any suspicion of residual cancer, the testicle should be removed.
The standard of care is bilateral orchiectomy, and testosterone can easily be replaced.
In the case of most surgeries, infection is a possibility when undergoing a partial orchiectomy procedure. Following the surgery, patients will feel soreness, swelling, and possible bruising to the scrotum.
Patients may take over the counter painkillers during the recovery process. In addition, applying ice to reduce the swelling can provide pain relief. You should speak with their doctor about possible pain relief medication.
Men should refrain from any physical work or activities following this procedure. Participating in physical work or activities can cause further injury and issues to the groin area.