surgery to remove the testiclesIsraeli hospitals offer advanced surgical procedures, including nerve-sparing techniques. Successfully apply the latest techniques and prosthetic reconstruction. All this provides the most effective assistance with the fewest side effects. Most men withtesticular cancer(Testicular cancer), surgery is recommended. Mainly determined by the type of surgery, stage of cancer. In the planning team of doctors also considers factors such as levels of tumor markers in serum and the desire to have children.

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Surgery in the treatment of testicular cancer has the following objectives:

  • Diagnosis and staging.
  • Complete removal of the tumor.
  • Resection of the tumor has spread to other parts of the body, eg, lung.
  • Removal of residual abnormal tissue after radical orchiectomy and chemotherapy .

The following types of transactions are most often used to treat testicular cancer. Prior to surgery and after other therapies may be recommended.

Radical orchiectomy - surgery to remove the testicle

Radical inguinal orchiectomy is used as an initial treatment at any stage of testicular cancer and usually during diagnosis. Removing the testicle - the only way to accurately diagnose the disease. If the neoplastic process has not spread outside of the body, there is a low risk of recurrence.

In some cases, prescribe chemotherapy before surgery for testicular cancer. The first stage of this disease, surgical intervention can be the sole treatment.

Radical orchiectomy is performed under general or spinal anesthesia (epidural) anesthesia. The surgeon performs a small incision in the groin, through which removes the testicle and spermatic cord in the scrotum. Through the scrotum body is not removed because of the risk that the cancer cells can spread to the lymph vessels. both testicles can be removed (bilateral orchiectomy), if doctors believe that they are afflicted with cancer. Typically, the operation takes about 30 minutes, the same day the patient can leave the clinic.

After removal of the testicles - after orchiectomy

Within approximately two weeks of man will feel some discomfort, which can be controlled with analgesics. Supporting shorts and loose pants will help to feel more comfortable. Around the treated area may experience numbness, which gradually passes. The sutures are removed after 5-10 days if they are not samorastvoryayuschimisya. Approximately two weeks will not be able to do hard work and drive.

After a while a man can return to normal sexual life.

With regard to fertility, orchiectomy does not make a man infertile. However, some patients are encouraged to use the services of a sperm bank for storing samples, if you have already been problems with fertility or egg is small in size and will probably produce less sperm.

retroperitoneal lymph node dissection

Retroperitoneal lymph node dissection is performed at stages I and II testicular cancer which does not respond to chemotherapy. This operation for testicular cancer is recommended if CT shows enlarged lymph nodes (more than 1 cm in diameter), which can contain cells that can become cancerous in the future.

It is a large and serious operation, which is performed by experienced surgeons specialized in Israeli hospitals. The patient explains in detail its essence, talk about the possible complications and side effects.

Before surgery, the patient losing blood and pass other tests to check the health of the heart and lungs. His advice about training.

abdominal middle performed long incision, and the surgeon removes the lymph nodes from the rear part of the stomach, the so-called retroperitoneum. If the resected lymph nodes only on the side where the tumor is located, the operation is called ipsilateral lymph node dissection when both sides - bilateral. This surgery for testicular cancer lasts several hours. It may hold with orchiectomy or later.

Laparoscopic retroperitoneal lymph node dissection

Men who are not undergoing chemotherapy can be offered laparoscopic surgery. This is influenced by a number of factors, including the stage. Minimally invasive surgery is highly specialized, it is done only by experienced surgeons Israel.

During operation, a few incisions in the abdomen through which a laparoscope is inserted, and other tools. The recovery process is faster, since it was not recessed, long incision. The period of hospitalization can take about 4 days.

Despite a more rapid recovery, there may be some complications. This may be damage to blood vessels, bowel bleeding, incomplete removal of cancer cells.

Before recommending laparoscopic surgery the patient is fully informed of the risks and uncertainties of this type of surgery. The operation was conducted by highly qualified surgeon with experience in laparoscopic surgery, the result of intervention is closely monitored by a team of doctors.

After retroperitoneal lymphadenectomy

During the first few days, the patient remains in intensive care, carried out careful monitoring of his condition.

Set dropper until the patient will not be able to eat or drink. It can be supplied to a wound drainage to remove excess liquid and to accelerate the healing process.

Patients are advised as soon as possible to begin to move. This will help reduce the risk of infection, blood clots. Wearing elastic stockings to prevent the formation of blood clots in the legs. A physical therapist will advise about exercises for the legs and breathing.

For pain control will analgesics. If it does not pass, can increase the dose of the drug.

Time spent in the hospital depends on how quickly the patient recovered, and whether there are any complications. Hospitalization period may take up to 10 days.

Probably a few months will pass before the patient fully recovered after surgery.

Possible complications of retroperitoneal lymphadenectomy

With any surgery there are risks of complications. The most common are bleeding and infection.

It may take some time before you recover the bowels. Doctors carry out regular checks for early signs of complications.

Sometimes, during surgery, surgeons are finding the lymph nodes that communicate with the adjacent structure, eg, the kidney. If you can not separate them, the kidney can be removed.

Effects on fertility

A common side effect of this operation is testicular cancer infertility due to separation of nerves during surgery. Retain the ability to ejaculate, but the sperm will come out into the bladder, and then out of the body with the urine. This condition is called retrograde ejaculation. Currently, it is becoming less of a problem due to the fact that the Israeli surgeons to effectively use nerve-sparing techniques, which help protect the nerves.

This operation generally does not have a physical effect on the ability to have an erection or orgasm. The doctor recommends that sperm before surgery.

Remove residual disease Operations

Sometimes testicular cancer are not fully respond to chemotherapy, which is administered after orchiectomy. Cancer that remains after these initial procedures, called residual disease, to remove that uses special operations. At high levels of tumor markers in the blood some men also recommended this type of surgery.

Such operations may include bilateral retroperitoneal lymph node dissection, if it was not carried out.

Surgery of metastases in Israel

Surgical interventions may be recommended to remove the secondary lesions that spread to the lungs, brain, neck or mediastinum. They are performed by experienced surgeons in specialized units.

Operation prosthetic testicle in Israel

The prosthesis can be placed in the scrotum immediately after surgery to remove the testicle, or later during another surgery. With a team of doctors discussing a patient all the moments of getting testicular prosthesis and the best time to host it, the advantages and disadvantages of this operation.

The prosthesis will have the same weight, shape, as well as the usual egg, the same will be felt, but not function. The operation is performed for cosmetic purposes.

Testicular prosthesis have a silicone rubber coating filled with silicone gel or saline. They are of different sizes, the doctor selects the appropriate one.

Operation prosthetic testicle carries a surgeon with special training. It may be applicable general anesthesia or local anesthesia. Running a small incision in the groin, the prosthesis is placed in the scrotum and fixed. After the restoration, usually the same day, you can leave the clinic.

Possible side effects and complications include infection, swelling of the scrotum, pain or discomfort, bruising, scar, displacement of the prosthesis, its rupture or leak.

After such operation of testicular prosthesis man usually require surgical intervention for prosthetic replacement in the future.

Israeli doctors use modern surgical techniques, trying to minimize potential adverse effects on the body.

Possible common side effects of operations for testicular cancer

  1. Pain is the result of tissue injury. The degree of its kind due to the surgery and the patient's pain threshold. Doctors prescribe analgesics for pain control.
  2. Vomiting and nausea may result from general anesthesia. Before the surgery, commonly prescribed drugs for the prevention and control of these symptoms. These are temporary manifestations that take place in a few days.
  3. In connection with a bleeding disorder or having unsealed blood vessel during surgery or orchiectomy dissection can cause bleeding. In order to control the state of the nurses regularly check the bandages and drains for the early detection of possible complications.
  4. The consequence of any kind of surgery can be wound infection. For the removal of excess fluid in the wound drains are placed. To prevent this side effect, as well as for its treatment prescribed antibiotics.
  5. Surgery to remove the testicle - one or both - will change the appearance of the body. The scrotum will look and feel empty for men. This can cause anxiety or confusion. Some patients opt for testicular prosthesis.
  6. Problems with fertility or infertility arise if both testicles are removed. Resection of one of them does not affect male fertility.
  7. Sexual disorders occur when the nerves that control ejaculation are damaged during a retroperitoneal lymph node dissection. This results in retrograde ejaculation, when semen into the bladder, and then outwardly from the body through the urethra. Nerve damage can also cause erectile dysfunction - the inability to obtain and maintain an erection sufficient for sex. These problems lead to infertility. Israeli surgeons have successfully used the technology during nerve-sparing operation for testicular cancer to maintain normal ejaculation. Before surgery it is important to discuss with the team of doctors matters of reproduction. sperm bank may be an option for some men.

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