Orchiectomy

WHAT YOU SHOULD KNOW

Risks

IF YOU'RE HEADING FOR THE HOSPITAL...

Before You Go

• The Week Before Surgery:
• You'll probably need to stop taking aspirin and ibuprofen; the doctor will tell you when. If you're taking aspirin for your heart, don't stop without asking the doctor first. Also ask whether you can take any over-the-counter medicines.
• Your doctor will tell you whether you need to have blood drawn.
• The Night Before Surgery:
• Your physician may suggest you take a sleeping pill.
• Just before surgery, you should not eat or drink anything (even water). Your doctor will tell you when to begin fasting.
• Call Your Doctor If...
• You have a cold or flu or are running a high temperature. The operation may need to be postponed.
• The problems for which you are having the operation get any worse.

When You Arrive

• Check with your doctor before taking insulin, diabetes pills, blood pressure medicine, heart pills, or any other medication on the day of surgery.
• Do not wear contact lenses to the hospital. You may wear glasses.

What to Expect While You're There

• Taking Vital Signs: These include your temperature, blood pressure, pulse (counting your heartbeats), and respirations (counting your breaths). A stethoscope is used to listen to your heart and lungs. Your blood pressure is taken by wrapping a cuff around your arm.
• Blood Tests: You may need blood taken for tests. It can be drawn from a vein in your hand or from the bend in your elbow. Several samples may be needed.
• Chest X-ray: Your doctor will check this picture of your heart and lungs to make sure you're up to the surgery.
• Heart Monitor: (Also called an electrocardiogram [e-LEK-tro-KAR-di-o-gram] or EKG). Typically, three to five sticky pads are placed on different parts of your body. Each pad has a wire that is hooked to a TV-type screen or to a small portable box (telemetry unit) that shows a tracing of each heartbeat.
• IV: A tube placed in your vein for giving medicine or liquids. It will be capped or have tubing connected to it.
• Pulse Oximeter: With a little clip connected to your ear, finger, or toe, this machine measures the oxygen in your blood.
• Anesthesia: This medicine will make you comfortable during surgery. Depending on the type of anesthesia, you may be awake during the operation, or completely asleep. You and your doctor will decide which approach is best for you. There are three possibilities:
• Spinal Anesthesia: In this type of anesthesia, a pain-killing medication is injected into your spine. It will leave you awake during surgery, but numb below the waist. Feeling will return in about 2 hours.
• Epidural Anesthesia: This approach requires insertion of a tiny tube into the spinal area. The tube is left in place so that you can be given additional pain-killing medication, if needed. As with spinal anesthesia, you will be awake during surgery, but numb below the waist.
• General Anesthesia: This type of anesthesia puts you completely to sleep. It is given either as a liquid in your IV or as a gas through a face mask or endotracheal (END-o-TRA-kee-ull) tube placed in your mouth and throat.

During Surgery:

After Surgery:

• Oxygen: After the operation, your body may need extra oxygen. It is given either through a plastic mask over your mouth and nose or through nasal prongs. If the oxygen dries out your nose or the nasal prongs bother you, tell your nurse, but don't take off the oxygen on your own.
• Deep Breathing and Coughing: These exercises help prevent a lung infection after surgery. Deep breathing opens the tubes going to your lungs. Coughing helps to bring up sputum from your lungs and keep them clear. You should deep breathe and cough every hour while you are awake, including any time you spend awake during the night.
• Hold a pillow tightly against your abdomen to help reduce pain from your incision. Take a deep breath and hold it as long as you can. Then push the air out of your lungs with a deep strong cough. Put any sputum that you have coughed up into a tissue. Take 10 deep breaths in a row every hour while awake. Remember to follow each deep breath with a cough.
• Incentive Spirometer (spy-ROM-uh-tur): This piece of equipment helps you take deeper breaths. Put the plastic nozzle into your mouth, take a very deep breath, and hold it as long as possible. Then blow as hard as you can into the mouthpiece. Take 10 deep breaths in a row every hour while awake. Remember to follow each deep breath with a cough.
• Ice: For pain or swelling, you may put ice in a plastic bag, cover it with a towel, and place this over the surgery area for 15 to 20 minutes out of every hour as long as necessary. Do not sleep on the ice pack. Treatment with ice is most effective when started right after surgery and used for 24 to 48 hours.
• Heat: After the first 24 to 48 hours you may use heat for pain or swelling. Use a heating pad (turned on low) or a hot water bottle, or sit in a warm water bath for 15 to 20 minutes out of every hour as long as you need it. Do not sleep on the heating pad or hot water bottle. Heat brings blood to the area of the surgery and helps it heal faster.
• Activity: You may need to rest in bed for a while. But even if you are confined to bed, it's important to exercise your legs in order to stop blood clots from forming. Lift one leg off the bed and draw big circles with your toes, then repeat with the other leg. You can also try lying on your side and pretending to pedal a bike. When you're told it's OK to get out of bed, make sure someone is with you the first time you try. If you feel weak or dizzy, sit or lie down right away.
• Strict Intake/Output: Your doctor may need to know the amount of liquid you are taking in versus the amount you lose in your urine. This is often called an "I&O."
• Unless told otherwise, drink 6 to 8 large glasses of water each day. Keep a record of exactly how much liquid you drink.
• Your output of urine may have to be measured. Ask your doctor whether it's OK to use the toilet.
• Drains: Thin rubber tubes may be put into your skin to drain fluid from the area around your incision. They will be taken out as soon as they are no longer needed.
• Medicines:
• Antibiotics: These medicines help prevent bacterial infection. They may be given by IV, as a shot, or by mouth.
• Pain Medicine: To ease pain after the operation, your doctor will probably prescribe medication to be given by IV, as a shot, or by mouth. Tell the doctor or your nurses if the pain won't go away or keeps coming back.
• Anti-Nausea Medicine: This medicine calms your stomach and controls vomiting. Your doctor may suggest you take it at the same time as your pain medicine, which sometimes upsets the stomach.
• Stool Softeners: These medications make bowel movements softer so you won't need to strain.

After You Leave

• You may use heat to reduce pain and swelling. Heat brings blood to the injured area and helps it heal faster. Use a heating pad (turned on low) or a hot water bottle, or sit in a warm water bath for 15 to 20 minutes out of every hour as long as you need relief. Do not sleep on the heating pad or hot water bottle; you could get a burn.
• You'll need to keep a fluffy bandage on your stitches with the help of an athletic supporter. Keep the bandage and supporter clean and dry. You may take off the bandage after a few days, but should continue wearing the supporter during the day until your doctor says otherwise. You may remove it at night.
• When you bathe or shower, carefully wash your stitches with soap and water and then put on a clean, new bandage. You should change your bandage any time it gets wet or dirty.
• Regular bowel movements can be difficult after surgery. Don't strain if the stool is too hard. Walking will help to stimulate the bowels. Eating foods rich in fiber, such as fruit, bran, cereal, and beans, will also help restore regularity. Drink plenty of liquids; prune juice may help make the stool softer. Or, if your doctor approves, you can take an over-the-counter fiber laxative.
• You'll need more rest after surgery, especially if you're getting follow-up radiation treatments or chemotherapy. Increase your activity slowly and rest whenever you feel you need to. Start exercising slowly as soon as you feel stronger and do more as you get better. Exercising makes the heart stronger, lowers blood pressure, and keeps you healthy. Your doctor will tell you when it's safe to start lifting heavy objects.
• Eat healthy foods from all the 5 food groups---fruits, vegetables, breads, dairy products, meat and fish. A balanced diet will make you feel better and have more energy. It also aids healing.
• Drink 6 to 8 large glasses of liquid each day. (If you are on a fluid limit, follow your doctor's advice.) You may take water, juices, and milk, but cut down on caffeinated beverages such as coffee, tea, and soda.
• Your doctor will tell you when it's safe to start driving, when you can go back to work, and when you can resume having sex. If you also get radiation or chemotherapy, you should use birth control for 12 to 18 months. The treatments can temporarily damage sperm in the remaining testicle, increasing the risk of abnormalities in the baby.
• Always take your medicine exactly as directed. If it doesn't seem to help, let the doctor know, but keep taking it until told otherwise. If you've been prescribed antibiotics, be sure to use them up, even if you're feeling better. If a medicine makes you drowsy, avoid driving or using dangerous machinery.
• Perform a testicular self-examination every month. Your doctor can show you how to do this.

Call Your Doctor If...

• Your incision is red or swollen, or you notice pus coming from it. This could mean an infection.
• Your stitches come apart.
• Your bandage becomes soaked with blood.
• You are running a high temperature.
• You feel faint or have fainted.
• You have a cough.

Seek Care Immediately If...

• You suddenly have trouble breathing or develop a chest pain. You could have a blood clot in your lungs, or might be allergic to a medicine you're taking.
• You are coughing up blood.