5 Reasons Why Men Lose Their Testicles

5 Reasons Why Men Lose Their Testicles

Testicular removal, or Orchiectomy, is a surgical procedure involving removing one or both testicles. This topic might seem unusual, but it's important to understand the reasons behind the procedure and what happens afterward. In this blog post, we'll discuss five reasons someone might undergo testicular removal, the anatomy involved in the process, and the potential impact on a person's lifestyle and physiology, including the development of secondary male sex characteristics. 

Understanding the Anatomy of Testicles

The testicles are located within the scrotum, which is part of the groin region. Each testicle is connected to a C-shaped structure called the epididymis, where sperm cells are stored. The spermatic cord contains blood vessels, nerve endings, and the vas deferens, which transport sperm cells outside the testicles. Testosterone deficiency can lead to various health issues, including androgen deficiency disorders and sexual dysfunction.

Orchiectomy

Orchiectomy is surgery to remove one or both testicles. This is mainly done to treat testicular cancer or advanced prostate cancer.

Types of Orchiectomies

Simple Orchiectomy: Involves making an incision in the scrotal sac and removing the Testicle and epididymis. This procedure is typically performed under local or general anesthesia and takes 30-60 minutes to complete.

Radical Orchiectomy: Involves removing the Testicle, epididymis, and spermatic cord through a higher incision near the inguinal canal. This procedure is more extensive and may be necessary in cases of testicular cancer, as it allows for more accurate staging and assessment of cancer spread.

Reasons for Testicular Removal

Testicular Torsion: Twisting the Testicle and spermatic cord within the scrotal sac causes severe pain and potentially cuts the blood supply. Immediate medical attention is required to preserve the Testicle; however, in some cases, removal may be necessary. Testicular torsion occurs in about 1 in 4,000 males under 25; early intervention is crucial to saving the Testicle.

Cryptorchidism (Undescended Testicle): A condition where the Testicle does not fully descend into the scrotal sac during development. According to the American Urological Association, cryptorchidism affects approximately 3% of full-term male infants and 30% of premature male infants. Approximately 80% of cryptorchid testes descend by the third month of life. This makes the true incidence around 1%.  In most cases, the Testicle will be surgically repositioned; however, removal may be considered in some situations (e.g., lack of medical care).

Testicular Cancer: The formation of abnormal cells in the Testicle may spread to other body parts. Early detection is crucial. The risk of testicular cancer is 5 to 10 times higher for males with undescended testicles than for the general male population. In the United States, testicular cancer affects about 1 in 250 men; with the highest incidence rates occurring in men aged 15-35. In some cases, a radical orchiectomy may be required to remove the Testicle, epididymis, and spermatic cord for staging and assessing the risk of cancer spread.

Trauma: Severe blunt force trauma or penetrating injuries can damage or rupture the Testicle. While repair is often the first course of action, the damage may be too extensive in some cases, necessitating removal. Testicular injuries account for about 1% of all traumas in men. Trauma to the testicles can result from various causes, including sports injuries, accidents, or violence.

Gender Reassignment Surgery: Involves the removal of both testicles as part of the transition process for transgender individuals. According to the World Professional Association for Transgender Health (WPATH), orchiectomy may be performed as part of gender-affirming surgeries, such as vaginoplasty or feminizing genitoplasty. The removal of both testicles is crucial to reduce testosterone production, which helps achieve a more feminine appearance and physiological state.

 Testicular failure: It begins before puberty will stop normal body growth. It can prevent adult male characteristics (such as a deep voice and beard) from developing. Testicular failure and low testosterone level may be hard to diagnose in older men because testosterone level normally decreases slowly with age. Symptoms depend on the age when testicular failure develops, either before or after puberty. Symptoms may include a decrease in height Enlarged breasts (gynecomastia) Infertility Loss of muscle mass Lack of sex drive (libido) Loss of armpit and pubic hair Slow development or lack of secondary male sex characteristics.

Treatment Male hormone supplements may treat some forms of testicular failure. This treatment is called testosterone replacement therapy (TRT). TRT can be given as a gel, patch, injection, or implant.

Life after Testicular Removal

Those who undergo the removal of one testicle can generally lead normal lives, maintain fertility, and produce adequate testosterone levels. A study published in the Journal of Clinical Oncology found that fertility rates in men who had one testicle removed due to cancer were similar to those of men who did not undergo orchiectomy. Prosthetic testicles may be offered for cosmetic reasons, with a patient satisfaction rate of approximately 80%.

In cases where both testicles are removed, testosterone levels will drop significantly, impacting muscle mass, fat distribution, libido, and energy levels. A study in the Journal of Andrology found that men who underwent bilateral orchiectomy experienced a significant decrease in testosterone levels, which resulted in symptoms such as hot flashes, fatigue, and depression. Hormone replacement therapy (HRT) may be necessary for these situations to maintain normal physiological functions and well-being. According to the American Association of Clinical Endocrinologists, testosterone replacement therapy can improve mood, increase energy levels, and restore sexual function in men with low testosterone.

Some men may experience psychological and emotional challenges after testicular removal, including feelings of inadequacy or concerns about body image. In a study published in the journal Psycho-Oncology, men who underwent orchiectomy reported higher levels of body image concerns and depression compared to men who did not have the procedure. Patients need access to psychological support, such as counseling or support groups, to help cope with these issues.

Men who have undergone orchiectomy may also experience complications related to testicular failures, such as difficulty urinating, blood clots, or increased risk of infection. It is essential for patients to discuss these risks with their healthcare providers and to follow postoperative care instructions carefully to minimize the likelihood of complications.

 Final Thoughts: 

While testicular removal may seem daunting, understanding the reasons behind the procedure and what to expect afterward can help alleviate concerns. The impact on an individual's life will depend on specific circumstances, but people can still lead normal, healthy lives in many cases. In some instances, hormone replacement therapy or prosthetic testicles may be necessary to maintain normal physiology, healthy sperm production, and appearance.

It is essential for patients to discuss their concerns and questions with their healthcare providers and to seek support from friends, family, or support groups. By staying informed and actively participating in their care, individuals can navigate the process of testicular removal with greater confidence and peace of mind.