Testicle Removal

The testis is removed through the scrotal incision (testicle removal phase). If the patient chooses and if no contraindications are present, a prosthetic testis is inserted into the scrotum before the wound is closed in layers by suturing. An alternative method uses an incision in the groin. The testis is pulled up through the incision after cutting and trying the cord in a fashion similar to the scrotal approach. Dr. Elist performs a radical testicle removal by removing en bloc the contents of half of the scrotum. An incision is made in the inguinal area from the pubic bone up towards the lateral pelvic bone. The incision made deep into the tissues and the spermatic cord is dissected free and cross-clamped. The testis and all its associated structures are pushed up from the scrotum into the incision and removed. Packing is then placed in the empty scrotum. When the spermatic cord is opened and the individual bundles making up the cord are cross-clamped, cut, and secured with nonabsorbable suture material, care is taken to avoid important nerves and vessels in the area.

The packing is removed and bleeding controlled. A prosthetic testis may be placed in the scrotum before the incision is closed in layers by suturing. This procedure results in complete removal of the testis. If abdominal exploration is warranted, a midline incision is made from the upper to the lower abdomen and the abdominal cavity is entered. The back wall of the abdomen is exposed and the lymph nodes are checked for spread of tumor. Some may be removed and/or biopsied and the abdominal wound is closed in multiple layers by suturing. Testicle removal can be a dramatic life event for men. The resulting scrotal deformity and the uneven look of the scrotum can pose a serious psychological stress to many men resulting in decrease of self-esteem and even sexual dysfunction. Testicle removal can be accompanied by the insertion of uni or bilateral testicular prosthesis to achieve a natural look of the scrotum.