If an ultrasound shows a suspicious solid mass within the testicle, the usual initial operation is radical inguinal orchidectomy, also commonly written as radical inguinal orchiectomy. It is an operation to remove the affected testicle and spermatic cord through an incision in the groin.
Patients may search for this operation using phrases such as testicular cancer surgery, testis removal surgery, testicle removal operation, testicular tumour surgery, testicular mass removal, high inguinal orchidectomy, inguinal orchiectomy or operation for a testicular lump.
Dr. Swati H. Shah is a uro- and gynaecologic oncosurgeon in Ahmedabad with a surgical interest in testicular cancer and complex retroperitoneal disease. The right treatment plan depends on examination, ultrasound, tumour markers, staging and the suspected diagnosis.
Radical inguinal orchidectomy is the standard surgical approach when a testicular malignancy is suspected. The surgeon makes an incision in the groin, delivers the affected testicle through the inguinal approach and removes it together with the spermatic cord according to oncological principles.
The word radical refers to the extent and oncological approach to removing the affected testicle and spermatic cord; it does not mean that the operation is necessarily more extensive than required. The procedure is different from removal of the testicle through an incision in the scrotum.
Patients and reports may use several related terms:
These terms may be used in different contexts, but the exact operation should be confirmed from the surgeon’s plan and operative notes.
When a solid testicular mass is suspicious for cancer, the usual approach is through an inguinal incision rather than a scrotal incision or needle biopsy through the scrotum.
This approach follows established oncological principles and allows removal of the affected testicle and spermatic cord. A scrotal procedure may affect subsequent management and is generally avoided when testicular cancer is suspected.
The exact plan should be made by a specialist after reviewing the examination, scrotal ultrasound, tumour markers and relevant imaging.
The operation may be recommended when investigations identify a testicular mass suspicious for malignancy. Findings that may lead to specialist assessment include:
Normal tumour markers do not exclude testicular cancer. Similarly, an abnormal marker alone does not confirm the diagnosis. The clinical findings must be considered together.
In selected situations, additional assessment or a different management strategy may be appropriate. The surgeon should explain why the operation is recommended in the individual case.
Before surgery, the clinical team reviews the history, examination and investigations. Preparation may include:
The surgeon examines the testicle and reviews symptoms, medical history, medications, allergies and previous operations.
The ultrasound report and, when available, the images are reviewed to understand the location and appearance of the mass.
AFP (alpha-fetoprotein), beta-hCG (beta-human chorionic gonadotropin) and LDH (lactate dehydrogenase) are commonly measured before treatment. Other routine preoperative tests are based on the patient’s needs.
CT imaging of the chest, abdomen and pelvis may be advised depending on the clinical situation. Timing is planned by the treating team so that necessary staging and treatment are coordinated appropriately.
Testicular cancer can affect fertility, and chemotherapy or further treatment may have additional effects. If future biological parenthood is important, discuss semen analysis and sperm banking before treatment when feasible. Do not delay urgent medical assessment while arranging fertility services; the care team can help coordinate the timing.
If the patient is considering a testicular prosthesis, it can be discussed before surgery. The surgeon can explain whether placement at the time of orchidectomy or at a later date is appropriate.
The operation is generally performed under anaesthesia.
The details can vary with the clinical situation and the surgeon’s findings. A testicular prosthesis may be considered separately or at the same operation in selected patients, after discussion of suitability, risks and preferences.
The removed testicle is examined under a microscope by a pathologist. The histopathology report helps identify the tumour type and features that guide further management.
The report may describe:
Not every report includes every feature, and the terminology can differ. The pathology findings are interpreted with tumour markers and staging imaging; they do not always determine the entire treatment plan on their own.
After orchidectomy, the team reviews the histopathology, post-operative tumour markers and staging information. Further management depends on the tumour type and stage.
Possible pathways include:
Not every patient needs chemotherapy or additional surgery. Some patients may be suitable for surveillance, while others need further treatment. The plan should be individualised and follow-up is important.
Recovery varies according to general health, the extent of surgery and individual circumstances. The treating team will provide instructions on wound care, activity, pain relief and follow-up.
Patients commonly ask about:
Follow the discharge instructions provided by the treating team. Seek medical advice for increasing pain, fever, wound redness or discharge, significant swelling, bleeding, difficulty passing urine or other concerning symptoms. Sudden severe pain or rapidly worsening symptoms need urgent assessment.
There is no single recovery timeline that applies to every patient. Return to strenuous exercise and heavy lifting should be guided by the surgeon.
Many men with one healthy remaining testicle continue to produce sufficient testosterone. However, hormone levels and sexual function vary, and some patients may have reduced function due to pre-existing factors or treatment effects.
If symptoms suggest low testosterone—such as persistent reduced libido, fatigue or erectile difficulties—discuss appropriate evaluation with the treating clinician. Do not assume that symptoms are inevitable or that hormone treatment is required for everyone.
Removal of one testicle does not automatically mean that a person will lose sexual function. Individual outcomes depend on overall health, hormone function, emotional wellbeing and any additional treatment.
Many men can father children after removal of one testicle, especially if the remaining testicle functions normally. However, testicular cancer itself may be associated with impaired semen quality, and chemotherapy or other treatment can affect fertility.
If having biological children in the future is important:
Sperm banking preserves a potential option for future use; it does not guarantee a future pregnancy. Fertility decisions should be individualised.
A testicular prosthesis is an implant placed in the scrotum to provide the appearance and feel of a testicle. Patients may search for “artificial testicle,” “testicular implant,” “testis prosthesis” or “prosthesis after testicle removal.”
Some patients prefer a prosthesis for body image, symmetry or personal comfort after orchidectomy. Others do not want one. Both choices are valid, and the decision should be based on the patient’s preferences and medical circumstances.
In selected cases, a prosthesis may be placed at the time of orchidectomy. In other cases, placement may be considered later. Timing depends on the clinical situation, infection risk, treatment plan, anatomy and patient preference.
No. A prosthesis is for appearance and does not produce sperm or testosterone. Hormone production depends on the function of the remaining testicle and other relevant factors.
Discuss implant size, position, feel, expected appearance, risks of infection or displacement, possible discomfort, future procedures and whether immediate or delayed placement is preferable. A prosthesis cannot perfectly replicate a natural testicle, and expectations should be realistic.
As with any operation, radical inguinal orchidectomy has potential risks. The surgeon should explain which risks are relevant to the individual patient.
Possible issues include:
This list is not exhaustive. Individual risk depends on health, the operation and any additional procedures.
Dr. Swati Shah’s testicular cancer case gallery includes cases in which a testicular lesion and tumour-marker results led to high inguinal orchidectomy, followed by histopathology and staging.
These cases illustrate the sequence of assessment, surgery and pathological diagnosis. They are individual clinical examples and should not be interpreted as predicting another patient’s outcome.
Testis Cancer Case Summary: https://drswatishah.in/gallery/case-summaries/case-summaries-of-testicular-cancer/
It is the standard operation used when testicular cancer is suspected. The affected testicle and spermatic cord are removed through an incision in the groin.
Yes. “Orchidectomy” and “orchiectomy” are alternative spellings for surgical removal of a testicle. “Radical inguinal” describes the approach used for suspected testicular cancer.
No. Not every lump is cancer. Ultrasound and clinical assessment help distinguish suspicious masses from other conditions. When a solid intratesticular mass is suspicious for cancer, radical inguinal orchidectomy is generally the standard approach.
A scrotal biopsy is generally avoided when testicular cancer is suspected because it can compromise standard oncological management. The usual approach is inguinal orchidectomy, guided by specialist assessment.
Recovery differs between patients. Follow the surgeon’s advice about wound care, driving, work, exercise and lifting. The team will also arrange review of the pathology report and discuss any further treatment.
Not everyone needs chemotherapy. The decision depends on the tumour type, stage, tumour markers, imaging and individual risk factors. Surveillance or additional treatment may be recommended according to the findings.
Many men can, but fertility varies. Testicular cancer and its treatment may affect semen quality. Discuss semen analysis and sperm banking before further treatment when feasible.
A testicular prosthesis may be an option for appearance and body image. It does not produce sperm or testosterone. Timing, suitability and risks should be discussed with the surgeon.
Bring the scrotal ultrasound report and images, AFP, beta-hCG and LDH results, CT reports and images if performed, previous medical records and any histopathology or operative reports.
| Feature | Inguinal approach | Scrotal approach |
|---|---|---|
| Cord control | High ligation at the internal ring | Not achieved |
| Lymphatic drainage | Preserved, follows the testicular pathway | May alter drainage to inguinal nodes |
| Use in suspected cancer | Standard | Avoided |
Radical inguinal orchidectomy removes the testis and spermatic cord through a groin incision, with high ligation of the cord at the internal ring. A scrotal incision can alter lymphatic drainage and risk local spread, so it is avoided when cancer is suspected.
Yes. Sperm banking before orchidectomy or any chemotherapy is recommended, because treatment can reduce sperm quality for a time.
Yes. A testicular prosthesis can be placed at the time of orchidectomy or later, according to the patient's choice.
Selected videos and anonymised case summaries from Dr Swati Shah’s testicular cancer practice, shared for patient education. Every patient’s plan is individual, and a past case does not predict an individual result.
When a testicular tumour is suspected, the surgical approach is extremely important. A scrotal incision should generally be avoided because it can disrupt the normal lymphatic drainage pathways of the testis and potentially increase the risk of local tumour contamination and altered patterns of spread.
The standard oncological procedure for a suspected testicular malignancy is high inguinal orchidectomy. Through an inguinal approach, the testis is delivered and removed along with the spermatic cord and its vascular and lymphatic pedicle, providing appropriate oncological control and allowing accurate histopathological diagnosis.
This is an important surgical principle: the first incision matters. An incorrect approach can complicate subsequent management, while the appropriate initial procedure can help ensure proper staging and treatment.
जब टेस्टिकुलर ट्यूमर (Testicular Tumour) का संदेह हो, तो सर्जरी का सही तरीका बहुत महत्वपूर्ण होता है। आमतौर पर अंडकोष (Scrotum) पर चीरा लगाने से बचना चाहिए, क्योंकि इससे अंडकोष की सामान्य लिम्फेटिक ड्रेनेज (Lymphatic drainage) प्रभावित हो सकती है और स्थानीय रूप से ट्यूमर कोशिकाओं के फैलने तथा बीमारी के फैलाव के तरीके में बदलाव का जोखिम बढ़ सकता है।
संदिग्ध टेस्टिकुलर कैंसर में मानक ऑन्कोलॉजिकल सर्जरी हाई इंग्वाइनल ऑर्किडेक्टॉमी (High Inguinal Orchidectomy) है। इसमें जांघ के ऊपरी हिस्से के पास इंग्वाइनल (Inguinal) रास्ते से अंडकोष को बाहर निकालकर, उसे स्पर्मेटिक कॉर्ड (Spermatic cord) तथा उसकी रक्त वाहिकाओं और लिम्फेटिक पेडिकल (Lymphatic pedicle) सहित हटाया जाता है। इससे उचित कैंसर सर्जरी सुनिश्चित होती है और सही हिस्टोपैथोलॉजिकल डायग्नोसिस (Histopathological diagnosis) में मदद मिलती है।
यह एक महत्वपूर्ण सर्जिकल सिद्धांत है: पहला चीरा बहुत मायने रखता है। गलत तरीके से किया गया पहला ऑपरेशन आगे के उपचार को जटिल बना सकता है, जबकि सही शुरुआती सर्जिकल प्रक्रिया बीमारी की उचित स्टेजिंग और आगे के उपचार में मदद करती है।
Advanced testicular cancer can still be curable, even when large residual lymph node masses remain after chemotherapy.
In this case, a 30-year-old man with a mixed germ cell tumor of the testis received systemic chemotherapy and subsequently underwent evaluation for a residual retroperitoneal lymph node mass. PET-CT showed significant residual masses measuring approximately 6 × 5 cm and 5 × 5 cm, located close to major blood vessels, including the aorta, inferior vena cava (IVC), and renal vessels.
Because of the size and location of the residual disease, surgery was technically challenging. The patient underwent exploratory laparotomy with retroperitoneal lymph node dissection (RPLND). Despite the close relationship of the tumor to the major vessels, a complete surgical resection was achieved safely, with removal of all visible residual tumor tissue.
This video presents a compelling testimonial from a testicular cancer survivor who received life-saving treatment from Dr. Swati Shah, an expert Uro and Gynecological Oncologist. In the brief clip, the patient recounts their challenging medical journey, focusing on the critical decision-making process regarding their surgical treatment plan. Initially confronted with the difficult prospect of traditional open surgery—which typically involves a longer, more painful healing process—the patient instead opted for a state-of-the-art robotic surgery performed by Dr. Shah. The survivor shares how this advanced, minimally invasive approach made a massive difference in their overall recovery.
In the video, He speaks in Gujarati, sharing his personal experience. He explains that he initially visited the clinic because he was experiencing significant pain. After a thorough medical evaluation, he was diagnosed with cancer and advised to undergo surgical intervention. Guided by the medical expertise of Dr. Swati Shah, He confidently went ahead with the recommended operation. The surgery was a success, and he reports receiving a highly positive response to the procedure. Following the operation, his comprehensive treatment plan also included a round of chemotherapy to reduce the risk of relapse.
The patient explains that he was initially diagnosed with testicular cancer five years ago. Unfortunately, eight months prior to the video, he faced a recurrence involving a retroperitoneal lymph node. After finding Dr. Swati Shah online, he underwent a complex robotic Retroperitoneal Lymph Node Dissection (RPLND) surgery performed by her. Speaking just two months post-operation, the patient highlights his remarkably smooth and rapid recovery, noting that his follow-up medical reports have all been positive. He expresses deep gratitude and recommends Dr. Shah.
A 19-year-old man presented with rapid testicular swelling and abdominal discomfort for about two weeks. A 3.5 cm testicular lesion and a markedly raised AFP (above 1000) pointed to a high-risk non-seminomatous germ cell tumour (NSGCT), and prompt high inguinal orchidectomy was planned.
A 31-year-old man had right scrotal swelling for six months. Ultrasound showed a 6.7 × 4.9 cm hypoechoic mass and AFP was 479.3, so high inguinal orchidectomy was advised, with histopathology and staging to follow.
Details are anonymised and shown for education only.
Dr. Swati Shah operated successfully and provided excellent care throughout the treatment. She is highly skilled, compassionate, and undoubtedly the best doctor for testis cancer in Ahmedabad. We are very thankful for her guidance and expertise
I had an excellent experience with Dr. Swati Shah. She is one of the most skilled and compassionate doctors I have ever met. Her approach is very professional, and she explains every step of the treatment with great patience and clarity. The surgery was successful, and recovery was smooth under her guidance.
We had surgery done in Apollo Hospital. The doctor is very good and has done the options in a very good way. Now everything is fine.
Dr. Swati H. Shah is a uro- and gynaecologic oncosurgeon in Ahmedabad with a surgical interest in testicular cancer and complex retroperitoneal disease.
If you have a suspicious testicular mass, have been advised to undergo radical inguinal orchidectomy, or need a second opinion about testicular cancer surgery, bring your ultrasound, tumour-marker results and other available reports for review.
Consultation: Shah’s Cancer & Robotic Surgery Centre, Gota, Ahmedabad.
Hospital: Apollo Hospital International, Ahmedabad, as appropriate.
Contact: +91 63590 11009
This page is for general education and does not replace an individual medical consultation. The recommended operation and further treatment depend on the patient’s examination, imaging, tumour markers and histopathology.
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