When is orchiectomy suitable for men and how is the surgery performed?

Applicable situations

1. Testicular tumor or other tumor in the scrotum.

2. Severe testicular damage, testicular necrosis due to spermatic cord torsion.

3. High-positioned cryptorchidism and atrophy, or testicular atrophy caused by old hematoma of the testicular tunica vaginalis.

4. Recurrent attacks of purulent epididymal orchitis or advanced epididymal tuberculosis.

5. Prostate cancer and a small number of patients with prostate hyperplasia who need castration.

Surgical method

Patients without tumors use an external scrotal incision, while patients with tumors use an inguinal incision.

1. Scrotal incision

a) 0.5% procaine was used for spermatic cord infiltration anesthesia at the inguinal ring on the affected side, and subcutaneous infiltration anesthesia was performed at the predetermined incision of the scrotal wall.

b) Make an oblique incision from the groin downward along the anterior wall of the scrotum, the length of which depends on the size of the tumor.

c) Cut the scrotal skin and levator testis fascia in layers, separate the spermatic cord at the upper end of the testis, separate the testicular artery and spermatic vein, ligate them at a high position, cut off their proximal ends and double ligate them.

d) The distal spermatic cord and testis are separated and lifted, and the parietal layer of the tunica vaginalis is incised to confirm the diagnosis. If there is no doubt, the testis and epididymis are removed together.

2. Inguinal incision

a) Under local infiltration anesthesia, make a parallel incision one finger width above the inguinal ligament, and cut the skin, subcutaneous tissue, and external oblique aponeurosis layer by layer without damaging the inguinal nerve and iliohypogastric nerve.

b) Free the spermatic cord to the internal abdominal ring, first separate, cut and ligate the vas deferens, then cut the spermatic cord tube at a high position, and ligate and bandage the proximal blood vessels with silk thread.

c) Separate the testicles down to the testicular ligament, cut and ligate it, and remove the testicle and epididymis.

d) Carefully stop bleeding on the remaining inner wall of the scrotum, place a rubber tube at the bottom of the scrotum for drainage, and suture the skin incision layer by layer.