Radical orchidectomy is the surgical removal of the testicle and spermatic cord via an inguinal approach, typically performed under general anaesthetic. It is the standard initial treatment for suspected or confirmed testicular cancer, and is usually carried out urgently following identification of a testicular tumour on clinical examination or ultrasound.
The operation involves a groin incision through which the testicle, epididymis, and the entire spermatic cord are delivered and removed en bloc. The spermatic cord is divided at the internal inguinal ring to ensure complete oncological clearance. A testicular prosthesis may be offered at the time of surgery or later, depending on patient preference and clinical factors.
Preoperative preparation, arranged by the oncology team, includes:
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Serum tumour markers (AFP, β-hCG, LDH)
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Staging CT scan (chest, abdomen, pelvis)
If adjuvant chemotherapy is indicated post-operatively, sperm banking is arranged by the oncologist to preserve fertility.
Indications include:
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Solid intratesticular mass suspicious for malignancy
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Rapidly growing, painless testicular enlargement
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Testicular tumour with abnormal tumour markers
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Select cases of testicular atrophy or trauma where malignancy cannot be excluded
Postoperative care includes:
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Wound care and monitoring for haematoma or infection
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Wearing snug scrotal and groin support for 7–10 days
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Avoiding strenuous activity for 2–3 weeks
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Referral to oncology for pathology review and treatment planning
Radical orchidectomy is both a diagnostic and curative procedure, providing histological confirmation, accurate staging, and—in early-stage disease—a high probability of complete cure.
