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Bilateral orchiectomy, or surgical castration, is a surgery to remove both testicles. It is a treatment option for locally-advanced and metastatic prostate cancer and aims to stop the production of androgens.

The surgery can be done under local anaesthesia. If you have a history of cardiovascular disease, your doctor may advise you to see a cardiologist before starting with hormonal drug therapy.

How is bilateral orchiectomy performed?

During surgery, you will lie on your back. You generally receive local or spinal anaesthesia. In some cases your doctor may recommend general anaesthesia. The surgeon makes an incision in the scrotum to remove both testicles. Because the tissue that surrounds the testicles is not removed, the scrotum will not look totally empty.

How do I prepare for the procedure?

Your doctor will advise you in detail about how to prepare for the procedure. If you need general anaesthesia, you must not eat, drink, or smoke at least for 6 hours before surgery. If you are taking any prescribed medication, discuss it with your doctor. You may need to stop taking it several days before surgery. Your doctor will advise you on when you can start taking it again.

What are the side effects of bilateral orchiectomy?

Complications after a bilateral orchiectomy are rare and include pain around the scrotum, bleeding, infection, or delayed healing of the wound. In most cases, the way the scrotum looks will not be affected by the surgery.

Recommendations for 2-3 weeks after the surgery:

  • Avoid heavy exercise
  • Avoid hot baths
  • Avoid the sauna

You have to see your doctor or go back to the hospital if you:

  • Develop a fever
  • Have severe pain
  • Notice that the wound starts to bleed or leak a transparent fluid

Bilateral orchiectomy results in permanent castration. This has physical and emotional consequences. Do not hesitate to discuss any concerns with your doctor. Together you can decide if other treatment options are more suitable for you.

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