Orchiectomy: What It Is and What to Expect
Medically reviewed by Sumiran Racherla, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor provides Orchiectomy?
A urologist usually performs an orchiectomy. A urologist is a surgeon who treats male reproductive and urinary problems. A cancer doctor, called an oncologist, may also be involved in your care. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What it is
Here, we cover orchiectomy as a cancer treatment. An orchiectomy is surgery to remove one or both testicles. The testicles are the main source of male hormones, such as testosterone. For cancer, the surgeon removes the whole tumor along with the testicle and the spermatic cord. The spermatic cord holds blood and lymph vessels.
Why a doctor might recommend it
Surgery is the first treatment for nearly all testicular cancers. Orchiectomy is also used as a form of hormone therapy for prostate cancer. Removing the testicles makes most prostate cancers stop growing or shrink for a time. It is rarely used today, because drug treatments can lower testosterone just as well without surgery.
How to prepare
- A sample of blood is taken before surgery to check tumor markers. These tests are often helpful in planning treatment and follow-up care.
- Men who want children can ask about sperm banking. This means freezing and storing sperm before treatment.
- If you want an artificial testicle, discuss it with your surgeon before surgery.
What happens during it
The surgeon makes a cut just above the pubic area. The testicle is removed through this opening. Blood and lymph vessels in the cord can act as pathways for cancer to spread. To lower that chance, these vessels are tied off early in the operation.
Recovery
Most men have some pain after the operation. Pain medicine can help, if needed. Tumor markers that keep rising or stay high after surgery are a sign that cancer has spread. A patient usually needs chemotherapy in that case. Some men choose an artificial testicle that looks much like a normal one.
Risks and side effects
Any surgery has short-term risks. They include reactions to anesthesia, too much bleeding, blood clots, and infections. If both testicles are removed, sperm cannot be made. Without testicles, a man cannot make enough testosterone. This can lower sex drive and affect erections. For prostate cancer, lower hormone levels can cause hot flashes. They can also cause less sexual desire and erectile dysfunction. Men treated with orchiectomy for prostate cancer are at higher risk of bone loss. Call 911 or go to the emergency room if you have bleeding that will not stop, trouble breathing, chest pain or discomfort lasting for two minutes or more, or fainting.
Who performs it
A urologist usually performs an orchiectomy. If lymph nodes are also removed, the surgeon should do this operation often. Experience is important for this operation.
Common questions
Does losing one testicle affect a man’s ability to have sex?
Losing one testicle usually has no effect on a man’s ability to have an erection or have sex.
What happens if both testicles are removed?
If both testicles are removed, sperm cannot be made, and the man becomes infertile. He also cannot make enough testosterone.
Is orchiectomy used to treat prostate cancer?
Yes, but it is rarely used today. Its main effect is as a form of hormone therapy.
Can the surgeon keep part of the testicle?
Sometimes, a partial orchiectomy takes out only the tumor and keeps healthy testicle tissue. Doctors can consider this for cancer in both testicles. They can also consider it for a single testicle with cancer or a poorly working other testicle. It is linked to a higher chance that the cancer comes back. Close lifelong monitoring is needed afterward.
How does a direct primary care or concierge doctor fit in?
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance.
Sources
- American Cancer Society - Surgery for Testicular Cancer
- American Cancer Society - Hormone Therapy for Prostate Cancer
- National Cancer Institute - Prostate Cancer Treatment (PDQ)
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
