Radical inguinal orchiectomy
A radical inguinal orchiectomy removes a testicle with a suspected or confirmed cancer, along with its cord, through a cut in the groin. It is the first step in treating nearly all testicular cancers, both to remove the tumor and to learn exactly what type it is.
Also called Radical orchiectomy, Inguinal orchiectomy, High inguinal orchiectomy, Radical orchidectomy, Orchidectomy, Testicular cancer surgery, Testicle removal for cancer, Remove my testicle
- Where
- Hospital or outpatient surgery center operating room
- Anesthesia
- General anesthesia, sometimes spinal anesthesia
- Time in the room
- About 1 hour, a little longer if an implant is placed
- Hospital stay
- Same day
- Back to normal
- 1 to 2 weeks for daily life; about 4 weeks before heavy lifting
- Back to work
- Desk work in about 1 week; heavy physical work after about 4 weeks
Overview
Testicular cancer is one of the most common cancers in young men, and one of the most curable. When an ultrasound shows a solid mass inside the testicle, removing that testicle is almost always the first step. A needle biopsy is avoided, because it could spread cancer cells. Removing the whole testicle gives the pathologist the full tumor to study, and for many men it is the main treatment they need.
The operation is done through a cut in the groin, never through the scrotum. The testicle's blood vessels and lymph channels run up through the groin into the belly. Working from the groin lets your surgeon tie off the cord high, close to where it enters the belly, before the tumor is handled. Cutting into the scrotum could spread cancer cells into the scrotal skin and into lymph channels that would not otherwise be involved.
Before surgery, you will have blood tests called tumor markers, scans to look for spread, and a chance to bank sperm. You can also choose to have a silicone testicular implant placed in the scrotum at the same time. Surgery is usually scheduled quickly, often within days to a week or two of finding the mass.
After surgery, the pathology report, repeat tumor markers and scans together decide the stage of the cancer and the next step. Many men need only careful follow-up, called surveillance. Others go on to chemotherapy, radiation, or surgery to remove lymph nodes at the back of the belly.
The parts of your body involved
Each testicle hangs in the scrotum from a spermatic cord, which carries its artery, veins, lymph channels, nerves and the vas deferens. The cord passes through the groin canal, a short tunnel in the lower belly wall, and then into the belly. Before birth, the testicles form high in the back of the belly near the kidneys and travel down into the scrotum. They keep their original blood supply and lymph drainage, so testicular cancer spreads first to lymph nodes deep in the back of the belly beside the aorta and vena cava, not to the groin. This is why the cord is tied high in the groin and why CT scans look at the belly.
- Testicle
Makes sperm and testosterone. Most testicular cancers start in the cells that make sperm, called germ cells.
- Tumor
A firm, usually painless lump inside the testicle, seen on ultrasound as a solid area.
- Spermatic cord
The bundle of vessels, lymph channels, nerves and the vas that holds up the testicle. It is removed with the testicle.
- Groin canal
The tunnel in the lower belly wall through which the cord passes. Surgery is done through it.
- Lymph nodes at the back of the belly
The first place testicular cancer can spread. They are checked with CT scans.
- Groin nerves
Small nerves that give feeling to the inner thigh, scrotum and base of the penis. Your surgeon protects them when possible.
Why it’s done
In adults, most solid masses inside the testicle turn out to be cancer. Removing the testicle through the groin is the standard way to diagnose and treat it.
- A clear diagnosis
The pathologist examines the whole tumor and names the exact type, such as seminoma or nonseminoma. Each type is treated differently.
- Removing the main tumor
Taking out the testicle removes the cancer at its source. For cancer that has not spread, this may be the only treatment needed.
- Staging information
The size of the tumor and whether it has grown into blood vessels or the cord help predict the risk of spread and guide the next step.
- Tracking the tumor markers
If marker levels were high, they should fall after surgery. Levels that stay up suggest cancer elsewhere in the body.
Other options
- Testis-sparing surgery
Only the tumor is removed and the rest of the testicle is kept. It is considered in selected men with a small mass, especially when the other testicle is missing or both testicles have tumors, or when the mass may well be harmless. It is done through the groin, often with the tissue checked during the operation.
- Repeat ultrasound for a tiny, uncertain spot
Very small spots that might not be cancer, with normal tumor markers, are sometimes watched closely with repeat ultrasound at specialized centers.
- Chemotherapy first
Rarely, when cancer has spread widely and a man is very sick, chemotherapy starts right away based on scans and tumor markers, and the testicle is removed later.
- No surgery
Not recommended. Testicular cancer can grow and spread, and most men are cured when it is treated promptly.
Getting ready
Tick items off as you go. Your checklist is saved on this device only.
As soon as the mass is found
Before surgery: protecting fertility
Before surgery: the implant decision
The day before and the morning of surgery
In the operating room, step by step
Press play or pick a step. Each drawing shows what your surgeon is doing at that moment. Your team may do some steps differently.
1. Going to sleep
You lie on your back on the operating table. The anesthesia team puts you to sleep, or sometimes numbs you from the waist down. The groin and scrotum are cleaned and draped.
After the operation
Right afterward
- Recovery room
You wake up with a sore groin and a dressing. Most men are surprised that the scrotum hurts less than the groin.
- Pain control
You get pain and nausea medicine as needed and can usually eat and drink right away.
- Passing urine
The team checks that you can pass urine before you leave.
- Going home
Most men go home the same day, 1 to 3 hours after surgery, with a driver and written instructions.
- When results come
You will be told when to expect the pathology report, usually within about a week, and when to repeat the tumor markers.
At home
- Pain
The groin feels like a pulled muscle for 1 to 2 weeks. Acetaminophen and ibuprofen usually work. A short supply of stronger medicine may be prescribed for the first few days.
- Ice and support
Ice on and off for 48 hours. Wear snug briefs for 1 to 2 weeks, especially if you have an implant.
- The incision
Keep it clean and dry. Skin glue peels off in 1 to 2 weeks. Some bruising of the scrotum and base of the penis is normal.
- Showering
Usually allowed after 24 to 48 hours. No baths, hot tubs or swimming for 2 weeks.
- Activity
Walk from the first day. Avoid running, cycling and sports for about 2 to 4 weeks.
- Lifting
Avoid lifting more than about 15 to 20 pounds for about 4 weeks to let the groin wall heal. Your surgeon may give a different limit.
- Driving
Once you are off strong pain medicine and can brake hard without pain, usually after about a week.
- Sex
When comfortable, usually after 1 to 2 weeks. Erections and orgasm are normally unchanged.
- Work
Desk work after about 1 week. Physical jobs usually after about 4 weeks.
- Checking the other testicle
Keep examining your remaining testicle once a month. A new cancer on the other side is uncommon, but it is easiest to treat when found early.
Recovery timeline
- Day 0Home the same day
You go home a few hours after surgery with a sore groin and a snug support.
- Days 1 to 3Most sore
The groin is tender and the scrotum may be bruised. Rest, ice and pain medicine help.
- About 1 weekPathology and markers
The pathology report is usually ready. Tumor markers are rechecked, often more than once, to see if they are falling as expected.
- Weeks 1 to 3Staging and the plan
Scans, markers and pathology are reviewed together. You meet with your urologist, and often a medical oncologist, to decide on surveillance or further treatment.
- Weeks 2 to 4Next treatment, if needed
If chemotherapy, radiation or lymph node surgery is advised, it usually starts within a few weeks.
- About 4 weeksFull activity
Most men are back to lifting, sports and full work.
- First 5 yearsRegular follow-up
Visits with tumor markers and scans, more often in the first 2 years. The schedule depends on the type and stage of cancer.
- Long termLiving well
Most men are cured. Ongoing care includes self-exams, testosterone checks if you have symptoms, and attention to heart health after chemotherapy.
What it feels like
Everything happens fast. Many men go from finding a lump to surgery within a couple of weeks, often while still absorbing the word cancer. The physical recovery is usually quick. The emotional part can take longer.
Hearing the news
Shock, fear and disbelief are common, especially for young men who have never been seriously ill. Some feel embarrassed because of where the cancer is.
What helpsBring someone to your visits and write questions down. It helps to know that testicular cancer is one of the most curable cancers, even when it has spread.
Banking sperm
Giving a semen sample in a clinic on short notice can feel awkward and rushed, especially while you are scared.
What helpsSperm bank staff do this every day. If you can, give more than one sample. It is a small step that keeps future options open.
The morning of surgery
Many men feel anxious about losing a testicle and about what the surgery will show.
What helpsAsk the team to walk you through the plan once more. Your partner or a friend can wait for you and drive you home.
Waking up
The groin is sore and tight. The scrotum may feel strange, either empty on one side or with the unfamiliar firmness of an implant.
What helpsIce, pain medicine on a schedule and snug underwear. The strange feeling usually becomes familiar over weeks.
Waiting for pathology
The days until the pathology report and the repeat markers can feel long and tense.
What helpsAsk when and how you will get the results. Keep busy with short walks and people you trust.
Body image and intimacy
Some men worry about how they look or how a partner will react. Most find that sex, erections and orgasm feel the same.
What helpsTalk openly with your partner. An implant can be placed later if you change your mind. Your team can connect you with counseling or support groups.
Follow-up scans
Anxiety before each scan or blood test is very common, even years later.
What helpsAsk how results will reach you so you are not left waiting. Support groups for young men with cancer can help.
How well it works
The operation removes the tumor. Whether you need anything more depends on the pathology report, the tumor markers after surgery and your scans.
- The pathology report
It tells the type of cancer (seminoma, nonseminoma or a mix), its size, whether it has grown into blood or lymph vessels or the cord, and whether the edges of the specimen are clear.
- Tumor markers after surgery
If they were high, they should fall at a predictable rate: hCG roughly halves every 1 to 3 days and AFP roughly every 5 to 7 days. Markers that stay high or rise suggest cancer elsewhere.
- Stage and next steps
Cancer confined to the testicle (stage I) is often managed with surveillance alone. Spread to lymph nodes or beyond is treated with chemotherapy, radiation or lymph node surgery, depending on the type.
- Cure rates
Overall, more than 95 in 100 men with testicular cancer are cured. When the cancer is confined to the testicle, nearly all are.
- Hormones and fertility
The remaining testicle usually makes enough testosterone. Some men later need testosterone treatment, especially after chemotherapy. Many men father children afterward, sometimes with help from banked sperm.
Risks
Every operation has risks. These are the ones people ask about most, with honest odds where good numbers exist. Your surgeon’s own results matter more than averages.
Common
Soreness at the incision for 1 to 2 weeks, like a pulled muscle.
Bruising of the scrotum and base of the penis is common and fades within 2 to 3 weeks.
A numb patch on the inner thigh, scrotum or base of the penis from stretching of a small groin nerve. It usually improves over months, though some numbness can last.
Less common
Blood can collect in the empty side of the scrotum, causing a tense, painful swelling. Most settle with rest; a few need draining.
Redness, warmth or drainage at the incision, usually treated with antibiotics.
The implant may feel firmer than a natural testicle, sit higher, or be felt as uncomfortable at first.
Most men make enough testosterone with one testicle, but some develop low levels, especially if the remaining testicle is small or after chemotherapy. Symptoms include tiredness, low sex drive and low mood.
Sperm counts can be lower after losing a testicle, and many men with testicular cancer had lower counts beforehand.
Rare
An infected implant, or one that works through the skin, usually has to be removed.
Ongoing nerve pain in the groin after healing is uncommon.
A bulge at the incision from a weak spot in the belly wall is rare.
Clots in the leg or lung are rare after this short operation.
Call your care team or go to the emergency room if
- Fever of 101°F (38.3°C) or higher, or shaking chills
- Swelling in the scrotum or groin that keeps getting bigger or becomes tense
- Bleeding that soaks through the dressing and does not stop after 10 minutes of firm pressure
- Redness spreading from the incision, pus, or a bad smell
- Skin over an implant becoming thin, red or broken, or the implant poking through
- Pain that keeps getting worse, or is not controlled by your medicine
- Swelling or pain in one calf, chest pain, or shortness of breath
Questions to ask your surgeon
- How likely is it that this is cancer, and what type do you suspect?
- Have my tumor markers been drawn, and what were they?
- Do I need CT scans before surgery or after?
- Can you arrange sperm banking before surgery, and how quickly?
- Am I a candidate for testis-sparing surgery?
- Should I get an implant now, later, or not at all? What are the risks?
- When will I get the pathology results, and how?
- What are the chances I will need chemotherapy, radiation or more surgery?
- Will I see a medical oncologist, and when?
- Will you check my testosterone now and in the future?
- How long should I avoid lifting, exercise and sex?
- How often will I need scans and blood tests afterward, and for how long?
Words you may hear
- Orchiectomy
- Surgery to remove a testicle. Also spelled orchidectomy.
- Radical inguinal orchiectomy
- Removal of the testicle and its cord through a groin incision, used for testicular cancer.
- Inguinal
- Having to do with the groin.
- Spermatic cord
- The bundle of blood vessels, lymph channels, nerves and the vas that holds up the testicle.
- Tumor markers
- Blood tests (AFP, hCG and LDH) that can be raised by testicular cancer and are used to track it.
- Germ cell tumor
- A cancer that starts in the cells that make sperm. Most testicular cancers are this type.
- Seminoma
- One main type of germ cell tumor. It tends to grow slowly and responds well to chemotherapy and radiation.
- Nonseminoma
- The other main type of germ cell tumor, often a mix of cell types, treated somewhat differently.
- Pathology
- The lab examination of tissue under a microscope to diagnose disease.
- Staging
- Working out how far a cancer has spread, using pathology, scans and blood tests.
- Retroperitoneal lymph nodes
- Lymph nodes deep in the back of the belly, where testicular cancer usually spreads first.
- Surveillance
- Careful follow-up with exams, blood tests and scans instead of immediate further treatment.
- Testicular prosthesis
- A silicone implant shaped like a testicle and placed in the scrotum.
- Sperm banking
- Freezing semen samples for possible future use.
Common questions
Why can't they do a biopsy first?
Putting a needle into a testicular tumor could spread cancer cells into the scrotum. Ultrasound and tumor markers are accurate enough that removing the testicle through the groin is the safest way to diagnose and treat it together.
Why is the cut in my groin and not my scrotum?
The testicle's blood vessels and lymph channels run up through the groin into the belly. Working from the groin lets your surgeon tie them off high before handling the tumor, and avoids spreading cancer cells to the scrotal skin.
Will I still have normal erections and sex?
Almost always, yes. One healthy testicle usually makes enough testosterone. Erections, orgasm and ejaculation are normally unchanged.
Will I be able to have children?
Many men do. Sperm counts can be lower, especially after chemotherapy or radiation, which is why banking sperm before surgery is recommended.
Should I get an implant?
It is a personal choice. An implant restores the look of the scrotum but feels firmer than a natural testicle. It can be placed during surgery or later, and many men are comfortable without one.
How soon does this need to happen?
Usually within days to a week or two of finding the mass. There is enough time to bank sperm and think about an implant, but surgery should not be put off.
Will I need chemotherapy?
Not necessarily. Many men with cancer confined to the testicle need only surveillance. The decision depends on the type, the pathology details, the markers and the scans.
Could I get cancer in my other testicle?
It is uncommon, but it happens in a small number of men. Check your remaining testicle monthly and report any change.
Sources this page draws on
- American Urological Association, Diagnosis and Treatment of Early Stage Testicular Cancer: AUA Guideline (amended 2023) (2019)
- European Association of Urology, EAU Guidelines on Testicular Cancer
- American Cancer Society, Testicular Cancer: Surgery for Testicular Cancer
- Urology Care Foundation, Testicular Cancer
Written November 2026. This page explains what usually happens. It is not medical advice and does not replace a conversation with your own surgeon, whose plan for you comes first.