Thyer Urology

The testis is a paired organ that sits within either side of the scrotum. The spermatic cord is a bundle of structures (including blood vessels, nerves and vas deferens) that runs between the abdomen and the testicle.

Testicular cancer is the most common form of cancer in young Australian men. Radical orchidectomy is performed to remove the testis and spermatic cord when cancer is suspected in the testicle.

Pre operation

Ten days prior to the procedure you should:

• Notify Mr Thyer’s rooms if you are taking any blood thinning medication
• Ensure that sperm banking has been completed at a fertility clinic
• Ensure that you have had the CT scan and tumour marker blood tests

The procedure

On arrival at hospital you will be prepared for theatre by nursing staff. Mr Thyer will see you just prior to being taken into the operating theatre. You will have a short general anaesthetic. The procedure should take approximately 30 minutes. Mr Thyer will make a small incision in groin on the affected side, deliver the testis, divide the spermatic cord and send the specimen to the pathologist for microscopic analysis (you make incur a pathologist fee). The wound in the groin will be closed with dissolving sutures. After the operation you will be checked by the nurse. Most men stay one night in hospital but occasionally some men go home the same day.

Risks

• Bleeding. Bleeding from the operation site is very rare. Very rarely a readmission to hospital may be required to control bleeding.
• Infection. Wound infection is rare but may require a course of oral antibiotics to correct.
• Injury to ilio-inguinal nerve. This nerve supplies sensation to a small area of skin on the lateral scrotum and medial thigh. If the nerve is injured, then there will be reduced sensation in this area but this usually recovers over a few months in most men.
• Need for chemotherapy. A referral to a medical oncologist will be made to discuss follow up chemotherapy if the lesion is cancerous.
• Infertility. Testicular cancer and treatment for it will reduce your fertility. Sperm banking should be undertaken prior to radical orchidectomy.
• Hernia. There is a very small increased risk of hernia following this
• Benign mass. In 10% of cases the lesion in the testis is found to be benign (non-cancerous) and no further treatment is required in this case.
• There are risks with any general anaesthetic which are very rare including blood clots, heart or lung problems and adverse drug reactions. The anaesthetist will discuss these with you at the time of the procedure.

Follow up

Mr Thyer’s rooms will contact you to arrange a follow up appointment 1-2 weeks after the procedure to check your recovery and pathology. You should rest, avoid heavy lifting, exertion and sexual intercourse for 2 weeks following the procedure.

When to contact Mr Thyer

Following the procedure, you should contact Mr Thyer if you:

• Have a fever over 38 Degrees
• Develop significant and worsening scrotal swelling
• Have not received a follow up appointment
• You can contact Mr Thyer via his rooms during working hours or after hours via the after hours nurse at Hollywood Hospital on (08) 9346 6000
• You can attend the emergency department at the hospital at which you had your procedure. (Hollywood Private Emergency Department charge a fee for attendance).