Surgery for testicular cancer

You have been diagnosed with a possible testicular cancer, and been referred for an orchidectomy. This leaflet will help explain the following.

• What testicular cancer is.

• What the causes, signs and symptoms are.

• How testicular cancer is diagnosed.

• What an orchidectomy is.

• Whether there are any alternatives.

• What the advantages are to having surgery.

• What happens if you choose not to have surgery.

• What happens before and after the operation.

We hope this leaflet answers some of the questions you may have. If you have any further questions or concerns, please speak to a member of your healthcare team.

What is testicular cancer?

What causes testicular cancer?

The cause of testicular cancer is unclear. However several factors have been noted in relation to the disease. For example:

• Undescended testes that are not corrected in early childhood. Undescended testes are testes which have not dropped into the scrotum.

• Any other disorders of testicular development.

After treatment we recommend that you examine your testis every month.

What are the signs and symptoms of testicular cancer?

Most often testicular cancer begins with a hard painless lump. You may also have a dull ache, heaviness, or pain in your scrotum. Sometimes your scrotum is swollen and you cannot feel the normal testicle inside it.

The lump or swelling can be there for quite a while, or it can appear almost overnight and be very painful. Very rarely, your whole scrotum (left and right sides) is swollen.

How is testicular cancer diagnosed?

Different problems can produce different symptoms and different findings on examination. The most important things are:

• your history (a record of past events); and

• a physical examination of your scrotum. Sometimes it is impossible to determine what is inside the scrotum by performing a physical examination alone.

Other tests may include the following.

• Harmless ultrasound sound-waves are aimed at your scrotum. The sound-waves bounce back (the echo’s) and are seen as a picture on a screen. This is a painless, convenient, and highly accurate way to examine organs and tissues inside your scrotum.

• Tumour markers are blood tests. If tumour markers are raised, they signal certain types of testicular cancer. Not all testicular cancers will cause raised tumour markers, so having normal levels does not rule out the diagnosis.

• We like to perform a CT scan of the chest, abdomen, and pelvis of patients diagnosed with testicular cancer. This is to make sure the disease has not spread to other areas, particularly the abdominal lymph nodes. Your doctor will explain this scan in more detail.

What is an orchidectomy?

An orchidectomy is an operation to remove your testicle. The incision (cut) is made through your groin and not your scrotum.

Your surgeon will also give you the option of inserting a testicular prosthesis during surgery. They will discuss the benefits and risks of this with you before your procedure.

Are there alternatives to surgery?

There are, in effect, no alternatives to this procedure. However, in a small number of cases, the surgeon may feel partial removal of the testis is an option.

You will discuss your treatment options with your surgeon before anything is planned.

What are the advantages to having surgery?

Removal of the entire testicle allows:

• full examination of the growth; and

• accurate assessment of a possible cancer.

Whereas a small biopsy of the growth may miss, or underestimate, a cancer.

During your operation, your surgeon can take a biopsy of your other testicle. This is helpful if it is small or looks abnormal on an ultrasound.

What happens if I choose not to have surgery?

If you chose not to have surgery, the hospital will discharge you back to your GP.

Are there any risks to having the operation?

Possible complications include the following.

• Wound infection needing further treatment or possible removal of the prosthesis; between 1 in 10 and 1 in 50 patients.

• Pain, infection, bleeding, or leakage of the implant, needing further treatment; between 1 in 50 and 1 in 250 patients.

• The implant may lie at a higher level. It may be a slightly different size and consistency to the other testicle. Between 1 in 2 and 1 in 10 patients.

• Dissatisfaction with how the area looks after surgery, if a prosthesis has been put in; 1 in 5 patients.

• If found, testicular cancer may not be cured by removal of the testicle alone; between 1 in 10 and 1 in 50 patients.

• Additional procedures may be needed. These include radiation, chemotherapy, or further surgery. Between 1 in 10 and 1 in 50 patients.

• As a result of further procedures, you may lose your fertility; between 1 in 10 and 1 in 50 patients.

• Your results may show no evidence of cancer; between 1 in 10 and 1 in 50 patients.

• Pain, infection, bleeding, or leakage of the implant, needing further treatments; between 1 in 50 and 1 in 250 patients.

• Unknown long-term risks from using silicone products; between 1 in 50 and 1 in 250 patients.

• Anaesthetic or cardiovascular problems, that may need intensive care. These problems include chest infection, pulmonary embolus, stroke, deep vein thrombosis, heart attack and death. Less than 1 in 250 patients. Your anaesthetist will estimate your individual risk.

If you have any concerns about these risks, please contact your GP or your cancer nurse specialist (CNS).

What will happen before my operation?

You will have a pre-assessment appointment before your surgery. At this appointment a nurse will discuss your general fitness for surgery. You will have a blood test and maybe an ECG, which records the rhythm of your heart.

How can I prepare for my surgery?

While you wait for your surgery date, you can start preparing for your operation. Research shows that fitter patients, who are able to improve their health and activity levels before surgery, recover more quickly. Taking an active role in planning and preparing for your operation will help you:

• feel in control

• leave hospital sooner, and

• get back to normal more quickly.

To help with this, you may be contacted by a member of the One You Kent (OYK) team. OYK work in the community, and help patients improve their general health. This includes help and advice on:

• Stopping smoking

• Losing weight

• Getting more exercise

More information can be found on the following web sites.

• One You Kent (Kent Community Health)

• Fitter Better Sooner Toolkit (Royal College of Anaesthetists)

What happens when I arrive at hospital for surgery?

On your appointment letter, you will find the following information.

• Where you need to go on the day of surgery. This will be Kent Ward or Day Surgery at Kent and Canterbury Hospital.

• The date and time of your operation

• Instructions on when you can eat and drink before surgery.

If you have any questions, please contact Kent Ward before the day of your surgery.

What happens on the day of my procedure?

Your urologist (or a member of their team) will briefly review your medical history and medications. To confirm your consent, they will discuss the surgery with you again. They will also confirm which testicle is being removed.

An anaesthetist will see you to discuss the options of a general anaesthetic or spinal anaesthetic. The anaesthetist will also discuss with you pain relief after your procedure.

We may give you a pair of anti-embolism stockings to wear, and a heparin injection to thin your blood. These help to prevent blood clots from developing and passing into your lungs. Your medical team will decide whether you need to continue these after you go home.

Why do I need to sign a consent form?

All patients must give permission before they receive any type of:

• medical treatment

• test, or

• examination.

Consent is usually given when you sign the consent form before your treatment. We may ask you to give your consent verbally (spoken rather than written consent).

• You must give your consent voluntarily.

• The hospital must give you all the information you need to make a decision about your treatment. This is so you can give us informed consent.  Please speak to staff if:

• staff have not given you this information, or

• they have but you still have questions. 

• You must be capable of giving consent. This means you understand the information given to you, and can make an informed decision.

When we ask you to give consent, please use this time to ask any questions you may still have. For more information, please go to the NHS Consent for Treatment web page. Remember, you can withdraw your consent for treatment at any time.

Will I have an anaesthetic?

Yes. You will have a general anaesthetic (you will be asleep for the procedure). A local anaesthetic is placed in your wound, so the wound should be numb when you wake up after surgery.

How long will I be in hospital?

The procedure takes approximately 30 minutes.

Most patients have this operation as a day case. This means that you can return home on the day of your operation. If you need to stay in hospital overnight, your surgeon will explain why.

Will I have stitches?

Yes. They are dissolvable and should dissolve within 2 to 3 weeks. Most stitches are placed under the skin so you cannot see them.

How will I feel after my operation?

Most patients have swelling and bruising of the scrotum after surgery. This may last for several days. The hospital will give you painkillers to take home, to help with any discomfort.

What should I do when I return home?

For the first week after your operation

• You may walk about and climb stairs, but do not overdo things.

• Be sensible and take regular breaks during the day. This will help to reduce any swelling of your scrotum and make you feel more comfortable.

• Do not lift heavy items; ask someone to do it for you.

• Do not do any strenuous exercise for at least a month.

• Wear jockey type shorts rather than boxer shorts.

Caring for your wound at home

• Do not remove the wound dressing or get it wet for 48 hours.

• Once you can shower again (after 48 hours) pat the wound dry. Do not rub the wound.

When can I drive again?

Do not drive for 1 to 2 weeks after your operation, or until you feel comfortable. Before you drive again you must be pain free and able to perform an emergency stop without discomfort.

When can I return to work?

Depending on the type of work you do, you should be able to return to work 2 weeks after your operation. If your work is physically strenuous you may need longer to recover. Please discuss this with your surgeon.

Will I need a follow-up appointment?

Yes. An outpatient appointment will be arranged and sent to you for 3 to 4 weeks after your operation. At this appointment you will discuss your results, and whether you need any further treatment.

An automatic appointment will also be made with an oncologist at Maidstone. The oncologist reviews all testicular cancer patients in the region. At this appointment you will discuss the need for second line treatments, such as chemotherapy. The need for this depends on the pathology result of your testicle, your CT scan, and your tumour markers. Not all patients need chemotherapy, many only have surveillance.

What if I have any questions or I feel unwell at home?

If you feel unwell or have concerns about your wound, please go to the Urgent Treatment Centre at Kent and Canterbury Hospital.

If you have any questions or concerns about your surgery, please contact Kent Ward or the urology / oncology clinical nurse specialists via the Cancer Careline.

• Kent Ward, Kent and Canterbury Hospital
  Telephone: 01227 783102

• Cancer Care Line
  Telephone: 01227 868666

References

• British Association of Urological Surgeons (BAUS). Testicular lump.

• British Association of Urological Surgeons (BAUS). Radical orchiectomy (removal of the testis) and insertion of a testicular prosthesis (implant). Leaflet No: 023 / 129. July 2023.

[Web sites last accessed 12 May 2026]

Ask 3 Questions

There may be choices to make about your healthcare. Before making any decisions, make sure you get the answers to these three questions:

• What are my choices?

• What is good and bad about each choice?

• How do I get support to help me make a decision that is right for me?

Your healthcare team needs you to tell them what is important to you. It’s all about shared decision making.

What do you think of this leaflet?

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• Patient Voice Team
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