Surgical castration for prostate cancer
Orchiectomy reduces testosterone levels to castration levels within 12 hours - faster than any drugs, which is important for bone pain and the threat of spinal cord compression. It is often performed subcapsularly: the testicular parenchyma is removed while preserving the membranes and appendages, which gives the best cosmetic result. The side effects are the same as with drug therapy: hot flashes, decreased libido, osteoporosis - they are corrected by a urological oncologist. The method is cost-effective for long-term treatment.
Indications
- testicular tumor - orchofuniculectomy using inguinal access (the first and mandatory stage of treatment);
- testicular necrosis after torsion or injury;
- purulent orchiepididymitis with abscess formation, testicular tuberculosis;
- atrophied testicle, causing pain;
- hormonal therapy for prostate cancer (bilateral orchiectomy);
- cryptorchidism in adults when reduction is impossible.
Consequences and prosthetics
One healthy testicle completely ensures hormonal and reproductive function. For bilateral orchiectomy, testosterone replacement therapy is prescribed (except in cases of prostate cancer). The cosmetic defect is eliminated with a silicone prosthesis, which can be installed immediately or later. Cryopreservation of sperm is recommended before tumor surgery.
