An orchiectomy is surgery to remove one or both testicles. It is usually an outpatient procedure, so you go home the same day. Expect soreness, swelling and bruising in the groin and scrotum, ice and snug scrotal support for the first days, and no heavy lifting for about two weeks. Cleveland Clinic says full recovery usually takes several weeks. Sources differ on when sports and sex resume, so your surgeon’s discharge sheet wins. The aftercare is similar for cancer surgery and gender-affirming surgery.
The short version
- Most orchiectomies are outpatient. You go home the same day (Cleveland Clinic: Orchiectomy).
- Plan on ice for the first day or two and supportive underwear for anywhere from 48 hours to a few weeks, depending on the sheet your surgeon gives you.
- Avoid heavy lifting for about two weeks. Sources put the return to sports, running and sex between one and four weeks.
- With one testicle removed, the other usually keeps making enough testosterone, and fathering a child is still possible. Removing both ends sperm production and changes hormone levels.
- If fertility matters to you, raise sperm banking before surgery.
What is an orchiectomy, and why do people have one?
The testicles make sperm and hormones, including testosterone. An orchiectomy removes one or both. Three main reasons bring people to it:
| Type | What it involves |
|---|---|
| Radical inguinal orchiectomy (testicular cancer) | An incision just above the pubic area. The testicle and spermatic cord come out together. The American Cancer Society (ACS) says surgery is the first treatment for nearly all testicular cancers. |
| Simple orchiectomy (for example, prostate cancer) | One or both testicles removed through a cut in the scrotum (CommonSpirit). For prostate cancer, ACS says the main effect is lowering hormones, and that it is rarely used today because drugs can lower testosterone as well. |
| Gender-affirming orchiectomy | Both testicles and part of the spermatic cord removed through a single scrotal incision, to help relieve gender dysphoria (Northwestern Medicine). |
Cleveland Clinic also lists severe injury and, rarely, testicular torsion as reasons. When the surgery is for cancer, a pathologist examines the tissue to confirm the diagnosis, and further treatment depends on the type and stage (Cleveland Clinic: Orchiectomy; ACS: Surgery for testicular cancer).
What are the first days like?
Most people have some pain, and over-the-counter acetaminophen or NSAIDs can ease it along with the swelling (Cleveland Clinic). Bruising of the scrotum and the base of the penis can last 1 to 2 weeks (UW Medicine: Simple orchiectomy). Northwestern says bruising and swelling can last several weeks, and numbness or tingling in the groin skin can last for months while nerves grow back (Northwestern Medicine: Gender-affirming orchiectomy).
Ice runs for the first 24 hours (UW Medicine), the first day or two (Cleveland Clinic) or the first 2 to 3 days (CommonSpirit). CommonSpirit gives 10 to 20 minutes at a time, every 1 to 2 hours while awake, with a thin cloth between the pack and your skin. Our frostbite warning explains why that cloth matters.
For support, Indiana University recommends a scrotal support or jockstrap for the first 3 to 5 days. Cleveland Clinic mentions a special garment for about 48 hours and says your provider may suggest supportive underwear. UW Medicine says 1 week. Dorset County Hospital says supportive underpants, not boxers, until the swelling settles (Dorset County Hospital NHS). CommonSpirit says snug underwear or compression shorts for the first few weeks, and suggests lying down for 15 minutes several times a day for the first 2 weeks to ease the swelling (CommonSpirit: Orchiectomy).
| When | What sources say |
|---|---|
| Day of surgery | Home the same day with a driver. No driving for 24 hours after anesthesia (Dorset County Hospital). CommonSpirit says 1 to 2 weeks, or until your surgeon agrees. |
| First 2 to 3 days | Ice, rest, supportive underwear. Showers after 24 hours to 2 days, depending on the sheet (UW Medicine, Dorset). |
| Weeks 1 to 2 | No lifting over 10 pounds (Indiana University, Northwestern). No baths or swimming for 2 weeks or more (Rainbow Health Ontario, CommonSpirit). |
| Weeks 2 to 3 | Most normal activities and work return, per CommonSpirit. Rainbow Health Ontario says 1 to 4 weeks off work, depending on the job. |
| Weeks 3 to 4 | Cleveland Clinic usually recommends waiting this long for sports, running, heavy lifting and sex. Dorset says avoid strenuous exercise for four weeks. |
The ranges are wide, partly because the operations differ: a groin incision or a scrotal one, one testicle or two.
Can you have a testicular prosthesis?
Often, if you want one. ACS says a saline-filled prosthesis can be placed in the scrotum and comes in different sizes. Some people want one and others don’t, and ACS says to discuss it with your surgeon before the operation (ACS: Surgery for testicular cancer).
What changes after one testicle, and after both?
With one testicle gone, ACS says the remaining one usually makes enough testosterone to keep you healthy (ACS: Fertility and hormone concerns), and that erections and sex are usually unaffected. CommonSpirit adds that you can still father a child.
With both gone, sperm can’t be made. Hormone levels drop, which can lower sex drive and affect erections, and can bring fatigue, hot flashes and loss of muscle mass. For cancer care, ACS says testosterone as a gel, patch or shot can avoid these effects (ACS: Surgery for testicular cancer).
If you already take hormones, your prescriber adjusts them. Northwestern tells patients to book that visit within 2 weeks of surgery and says the surgery may reduce the need for some hormone medications. Gender Health SF says taking hormones long term helps protect bone health and mood, with the plan set with your primary care provider (Gender Health SF: Orchiectomy).
Should you bank sperm before surgery?
Ask before the operation. ACS says people who might want biological children can consider storing sperm before treatment starts, and that testicular cancer can lower sperm counts enough to make a good sample harder to collect (ACS: Preserving fertility in men). Gender Health SF calls removal of both testicles a sterilizing procedure and says a fertility discussion with your care team is an important step. Rainbow Health Ontario lists fertility counseling and sperm banking among its pre-surgery considerations. Our guide to which fertility doctor to see covers the specialist who handles this.
What about the emotional side?
Cleveland Clinic says it’s normal for the surgery to affect how you feel about yourself and about sex. CommonSpirit says feeling sad or depressed afterward is common and suggests asking about support groups. Gender Health SF notes that some people feel more anxious or low after any surgery and asks you to tell your care team about changes in mood or sleep.
Where does recovery underwear fit in?
Your surgeon may send you home in a garment or tell you exactly what to wear. Follow that first. The sources otherwise describe snug underwear, compression shorts or a jockstrap.
Our recovery jockstrap holds an ice pack in place and keeps things from swinging, and our Nutsicle ice packs are shaped to fit its pocket. Recovery briefs do the same job in a brief. We built all three for vasectomy recovery. Check with your surgeon before using them after an orchiectomy, particularly over a fresh incision or dressing. One reviewer who wore our briefs after a gender-affirming procedure called them great post-op comfort. Our scrotal support guide covers other surgeries, including hydrocele surgery and hernia surgery.
When should you call your doctor?
Call 911 if you pass out or are short of breath (CommonSpirit).
Call your surgeon right away for any of these (Cleveland Clinic, CommonSpirit, UW Medicine):
- Fever or chills (UW Medicine uses 101°F, 38.3°C)
- Severe pain, or pain that medicine doesn’t ease
- Heavy bleeding, or blood soaking through the bandage
- A purple spot on the scrotum, which Cleveland Clinic says could be a hematoma
- Redness, warmth, pus or blood at the incision, loose stitches, or an incision that opens
- Trouble peeing, or being unable to pass stool or gas
- Calf pain, or swelling or color change in the leg or groin
- Loss of feeling in the scrotum. Some tingling near the incision is expected, so ask which kind you have.
Hot flashes, fatigue or sexual changes can come from lower hormone levels, and Cleveland Clinic says hormone supplements may relieve them, so tell your surgeon. If you don’t have a urologist yet, Find a urologist near you.
FAQ
How long does it take to recover from an orchiectomy? Cleveland Clinic says the recovery process usually takes several weeks. CommonSpirit says most normal activities return after 2 to 3 weeks. Cleveland Clinic suggests waiting 3 to 4 weeks for sports, running and heavy lifting.
How long should you wear scrotal support after an orchiectomy? It ranges from about 48 hours (Cleveland Clinic) to 3 to 5 days (Indiana University), 1 week (UW Medicine) or the first few weeks (CommonSpirit). Follow your surgeon.
When can you drive after an orchiectomy? Dorset County Hospital says not for 24 hours after sedation or general anesthesia. CommonSpirit says 1 to 2 weeks, or until your surgeon says it’s okay.
When can you have sex after an orchiectomy? UW Medicine says 1 week after a simple orchiectomy. Northwestern says 2 weeks, and Cleveland Clinic says 3 to 4 weeks. CommonSpirit says your doctor will tell you.
Can you get a prosthetic testicle with an orchiectomy? Often, yes. ACS says a saline-filled prosthesis can be placed in the scrotum. Discuss it with your surgeon before surgery.
Does removing one testicle affect testosterone or fertility? Usually not much. ACS says the remaining testicle usually makes enough testosterone, and CommonSpirit says you can still father a child. Removing both ends sperm production.
Should you bank sperm before an orchiectomy? If you might want biological children, ask before surgery. ACS says sperm banking before treatment is an option, and a reproductive urologist can help set it up.
Sources
- Cleveland Clinic: Orchiectomy
- CommonSpirit Health: Orchiectomy
- ACS: Surgery for testicular cancer
- ACS: Fertility and hormone concerns
- ACS: Preserving fertility in men
- Indiana University School of Medicine: Orchiectomy
- UW Medicine: Simple orchiectomy
- Dorset County Hospital NHS: Advice following an orchidectomy
- Northwestern Medicine: Gender-affirming orchiectomy
- Gender Health SF: Orchiectomy
- Rainbow Health Ontario: Gender affirming surgery, orchiectomy (summary for health care providers)
Editorial and informational. Not medical advice. Read the full disclaimer.
