Testicular Cancer Treatment
Testicular Cancer Surgery
Testicular cancer is among the most curable cancers in medicine, and surgery is where treatment begins. Removing the affected testicle establishes the diagnosis, identifies the tumor type, and for many men with early-stage disease is the only treatment required. Texas Regional Urology's board-certified urologists evaluate testicular masses promptly and perform testicular cancer surgery, with care at our offices in The Woodlands, Tomball, and Kingwood.
The First Step in Treatment
What Is Radical Inguinal Orchiectomy?
Radical inguinal orchiectomy removes the affected testicle along with the spermatic cord, through a small incision in the groin rather than through the scrotum.
That route is not an aesthetic preference — it is a rule. A testicular mass is never biopsied through the scrotum, because doing so risks disturbing lymphatic drainage patterns and spreading cancer cells along a new path. The groin approach allows the cord to be clamped before the testicle is mobilized, and it keeps drainage along its normal route.
The procedure is both diagnostic and therapeutic. There is no biopsy step beforehand: the diagnosis is made from the removed testicle, which is examined to determine whether the tumor is a seminoma or non-seminoma — a distinction that changes what comes next entirely.
For many men with early-stage disease, this is the whole treatment, followed by a structured surveillance schedule. Others go on to chemotherapy or radiation depending on the tumor type and stage. Learn more about testicular cancer.
That route is not an aesthetic preference — it is a rule. A testicular mass is never biopsied through the scrotum, because doing so risks disturbing lymphatic drainage patterns and spreading cancer cells along a new path. The groin approach allows the cord to be clamped before the testicle is mobilized, and it keeps drainage along its normal route.
The procedure is both diagnostic and therapeutic. There is no biopsy step beforehand: the diagnosis is made from the removed testicle, which is examined to determine whether the tumor is a seminoma or non-seminoma — a distinction that changes what comes next entirely.
For many men with early-stage disease, this is the whole treatment, followed by a structured surveillance schedule. Others go on to chemotherapy or radiation depending on the tumor type and stage. Learn more about testicular cancer.
Why It's Done This Way
Benefits and Rationale
Definitive Diagnosis
The removed testicle provides the tissue that identifies the tumor type and grade — information no scan or blood test can supply on its own.
Often Curative Alone
For many early-stage cancers, orchiectomy is the only treatment needed, with surveillance thereafter and no chemotherapy or radiation.
Outpatient Procedure
Most men go home the same day.
Preserves Normal Lymphatic Drainage
The inguinal approach avoids altering drainage pathways, which matters for accurate staging and for controlling the disease.
Rapid Path to Treatment
Because diagnosis and first treatment happen in one step, men move quickly from discovery to a plan — which matters in a cancer that can grow rapidly.
Who Needs It
Am I A Candidate?
Orchiectomy is indicated when evaluation identifies a solid mass within the testicle. That evaluation includes physical examination, scrotal ultrasound — which is highly accurate at distinguishing a solid tumor from benign conditions like a cyst, hydrocele, or varicocele — and blood tests for tumor markers.
Not every scrotal lump is cancer, and many turn out to be entirely benign conditions requiring no surgery at all. Ultrasound sorts this out quickly, which is why getting a lump checked is worthwhile even when it turns out to be nothing.
If you may want biological children, raise it before surgery. Sperm banking should be arranged beforehand, particularly if chemotherapy or radiation may follow.
Not every scrotal lump is cancer, and many turn out to be entirely benign conditions requiring no surgery at all. Ultrasound sorts this out quickly, which is why getting a lump checked is worthwhile even when it turns out to be nothing.
If you may want biological children, raise it before surgery. Sperm banking should be arranged beforehand, particularly if chemotherapy or radiation may follow.
What Happens
What to Expect
Before Surgery
You'll have an ultrasound, tumor marker blood tests, and staging imaging of the chest, abdomen, and pelvis. Fertility preservation should be discussed and arranged at this stage if relevant. You'll receive fasting instructions and need someone to drive you home.
The Day of Surgery
The procedure is performed under general or regional anesthesia and typically takes under an hour. A small incision is made in the groin, the spermatic cord is secured, and the testicle is removed. A testicular prosthesis can be placed at the same time if you want one.
The First Few Days
Most men go home the same day. Expect soreness, swelling, and bruising in the groin and scrotum. Ice, supportive underwear, and over-the-counter pain medication manage most of it.
The First Two Weeks
Avoid heavy lifting and strenuous activity. Most men return to desk work within a week and to full activity around two to four weeks.
Pathology and Staging
The removed testicle is examined to determine the tumor type and how far it has grown locally. Combined with your imaging and post-surgery tumor marker levels, this establishes the stage — and the stage determines whether you need further treatment or move directly to surveillance.
Follow-up
Whether you need additional treatment or not, follow-up is structured and ongoing: periodic exams, tumor markers, and imaging on a defined schedule. This is how the small number of relapses are caught early, while still highly curable.
Risks & Side Effects
Side Effects
Bruising and Swelling
Expected, sometimes dramatic-looking, and resolves over one to two weeks.
Fertility and Hormones
One healthy remaining testicle typically produces enough testosterone and sperm for normal function and fertility. Chemotherapy and radiation pose the greater fertility risk, which is why banking is discussed before treatment begins.
Numbness
A small area of numbness near the incision or upper thigh is common and often permanent, though rarely bothersome.
Body Image
Losing a testicle affects some men considerably and others not at all. A prosthesis is available for those who want one, and it is entirely a personal choice with no medical bearing on outcomes.
Other Risks
Bleeding, infection, hematoma, and anesthesia-related risks. Your surgeon will review these in full.
Answers to your Testicular Cancer Surgery Questions
Frequently Asked Questions
A scrotal biopsy risks spreading cancer.
Entering through the scrotum can disturb normal lymphatic drainage and create a new route for spread. The diagnosis is made instead from the testicle removed through the groin.
Usually not — one is typically enough.
A single healthy testicle generally produces adequate testosterone and sperm for normal function and conception. Chemotherapy and radiation carry the larger fertility risk.
Not always — many men just need surveillance.
For many early-stage cancers, surgery is the only treatment required, with structured monitoring thereafter. Tumor type and stage determine whether further treatment is warranted.
Yes, at surgery or later.
A saline prosthesis can be placed during the original operation or at a separate procedure afterward. It's a personal choice with no effect on cancer outcomes.
Very — among the highest cure rates.
Testicular cancer responds exceptionally well to treatment at every stage, including when it has spread at diagnosis. Early detection still matters because it often means less treatment.
Usually within a day or two.
A new testicular lump warrants prompt evaluation, and we prioritize these appointments. An ultrasound takes minutes and settles the question quickly.
Found a lump?
Get it checked this week.
An ultrasound takes minutes, and most scrotal lumps turn out to be benign. Getting checked and being reassured is a good outcome.
