Last updated: 05-Oct-2026
Send your discharge papers and latest reports ahead of your follow-up appointment, so the visit starts with them already read · +91-63590-11009
Dr Swati Shah
MS, DrNB (Surgical Oncology)
Testicular Cancer Surgeon · Apollo Hospital, Bhat, Gandhinagar · Gota OPD, Ahmedabad
Shah’s Gastro, Cancer & Robotic Surgery Centre. 18 years of experience in cancer surgery. ★★★★★ 4.99 from 84 Google reviews (Gota clinic) · 5.0 from 33 (Apollo, Bhat)
IN SHORT
After the groin operation most men go home within a day. A scrotum that turns tense, bigger and more painful is a warning, not bruising.
After RPLND, milky drain fluid or a swelling belly once food restarts points to a lymph leak. Tell the team that day.
During BEP chemotherapy, new breathlessness or a dry cough is reported at once. Bleomycin is then stopped for good, never given once more.
Radical inguinal orchidectomy is a day-case or overnight operation for a fit man. You sit out of bed and walk about two hours after waking, eat and drink normally the same day, and wear scrotal support with ice packs. Plain pain tablets are usually enough.
The next day the wound and scrotum are checked and most men go home. A phone or OPD review follows two to three days later, when you are told the date the histology report will be ready. At two weeks the wound is seen again, and the histology, staging CT and repeat blood markers are discussed.
Some bruising and soreness are expected. A scrotum that becomes tense, larger and more painful is not. That is a collection of blood (haematoma). It is checked with an ultrasound and drained if it is growing or pressing on the skin, rather than bandaged and watched.
Retroperitoneal lymph node dissection is major abdominal surgery, and the hospital stay is usually four to seven days. The single most useful thing to watch is the drain, on the days when the diet is stepped up.
On the day of surgery you sit out and take sips. On day one you take liquids, walk three times and use a breathing exerciser every hour; the urine catheter usually comes out. Over days two and three soft food is added and the drip is weaned.
If the drain fluid turns milky, or the belly swells, once food restarts, lymph is leaking (chylous ascites). The drain stays in. The diet is changed to a low-fat one with a special fat called MCT, and sometimes feeding goes into a vein for a while.
Before you leave, the operating surgeon tells you in person whether the nerves for ejaculation could be spared, and what that means for you.
BEP chemotherapy combines bleomycin, etoposide and cisplatin. Most side effects are expected and are managed by the medical oncology team. A few are reported at once.
Breathlessness or a dry cough. Bleomycin can injure the lungs. If it does, bleomycin is stopped permanently and the oxygen given is kept to the lowest safe level. If you later need RPLND, the anaesthetist is told in writing that you had bleomycin, because high oxygen and too much fluid during surgery can bring the lung injury on.
Kidneys, hearing and nerves. Cisplatin can strain the kidneys, so blood tests are checked before each cycle. Ringing in the ears, muffled hearing, tingling in the hands or feet, and white, cold fingers in the cold (Raynaud’s) are all reported, not endured.
Keep the dates. Cycles are given on time, at full dose. A low white count is managed with growth-factor injections rather than by stretching the schedule, because in this disease the timing is part of the treatment. A man who skips a cycle because he feels better is trading control of the disease for a relapse.
| What you notice | What it may be | What is done |
|---|---|---|
| Tense, swelling, painful scrotum after orchidectomy | Blood collection (haematoma) | Ultrasound; drained if growing |
| Milky drain fluid or growing belly after RPLND | Lymph leak (chylous ascites) | Drain kept, low-fat MCT diet, sometimes feeding by vein |
| Belly swelling with vomiting after RPLND | Slow bowel or a blockage | Stomach tube; CT if not settling in two days |
| Breathlessness or dry cough on bleomycin | Bleomycin lung injury | Bleomycin stopped for good, minimum oxygen, steroids |
| One swollen leg or chest pain | A clot | Doppler or CT scan; blood thinners |
| Rising creatinine on cisplatin | Kidney strain | Extra fluids, dose reviewed with the medical oncologist |
| Nothing comes out at climax after RPLND | Dry orgasm from nerve damage | Confirmed, explained, referral for assisted reproduction |
| New back pain or a lump, months or years later | Late relapse or a growing teratoma | Scan and markers; a growing teratoma needs surgery |
Some things after treatment are not chances. They are certain.
The full list of possible complications is gone through at the consent discussion: bleeding, wound infection, clots, a slow bowel, lymph leak, injury to the bowel, ureter or a major blood vessel, loss of a kidney, a return to theatre, and a risk to life that is real after post-chemotherapy RPLND. Your own figures are given there, not published here as averages.
Treatment that controls this cancer leaves a survivorship to look after. Morning testosterone is checked at one year and then from time to time. One remaining testis usually keeps testosterone normal, but not always; if it falls and causes symptoms, it is replaced, sometimes for life.
Blood pressure, sugar, cholesterol and weight are checked for heart risk. Hearing is tested if it has changed. Fertility is reviewed, with advice on assisted reproduction where needed, and you are made aware that a second, different cancer can occur later.
Late relapse is real in this disease, so follow-up does not stop at five years without a plan. Blood markers and scans are both done, because neither replaces the other. And the remaining testis is checked by you, every month.
This is dry orgasm. It happens when the nerves for ejaculation could not be spared. Orgasm still happens, but semen does not come forward. Tell us: it is confirmed, explained, and you are referred for assisted reproduction, using banked sperm if it exists.
Please do not. Cycles are given on time and at full dose because the timing is part of the treatment. Low blood counts are managed with injections, not by stretching the schedule.
Mild bruising and soreness settle over days. A scrotum that keeps getting tighter, bigger and more painful needs a call the same day and an ultrasound.
Most men with one testis keep normal testosterone, but not all. It is checked in the morning at one year and then periodically. If it is low and causing symptoms it is replaced, and some men need that long term.
Yes. It can be placed at the time of orchidectomy or at a later operation. It is self-funded, and the cost is discussed at the consultation.
The operations themselves, and how fertility is protected before them, are on the testicular cancer surgery and fertility page. The full overview is on the testicular cancer surgery page.
Shah’s Gastro, Cancer & Robotic Surgery Centre
Dr Swati Shah — MS, DrNB (Surgical Oncology) · Testicular Cancer Surgeon
Consultation at Gota OPD, Ahmedabad. Surgery at Apollo Hospital, Bhat, Gandhinagar.
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