The primary tumour is treated by radical inguinal orchidectomy. An incision is made in the groin and the spermatic cord carrying the testicular blood vessels is tied off. The testes and its coverings are removed en bloc. The testicle is not removed via the scrotum because this can lead to spread to the scrotal skin and the lymph glands of the groin.
The orchidectomy specimen is sent for histological analysis to determine the type of testicular tumour, i.e. seminoma or non-seminoma. Subsequent treatment will depend on the type and stage of disease.
Most of the treatment options affect fertility. This needs to be discussed with the patient prior to commencing treatment. If appropriate, semen should be preserved for possible future assisted reproduction.
Previously reviewed by Dr Pieter J le Roux MBChB, FRCS(Eng), FRCSI, FCS(SA)Urol.
Reviewed by Dr David Eedes, Oncologist, February 2011