Orchiectomy in Korea

Orchiectomy, the surgical removal of one or both testicles, is a critical procedure performed in Korea for various medical reasons. These include the definitive treatment of testicular cancer, hormonal therapy for advanced prostate cancer, and as part of gender-affirming surgery. Korean urologists and oncologists utilize modern surgical techniques, ensuring effective treatment and supportive care for patients.

Reasons for Orchiectomy & Diagnosis in Korea

Orchiectomy is performed for several key indications, each requiring specific diagnostic approaches.

• Testicular Cancer: The primary reason for unilateral orchiectomy (removal of one testicle). Early diagnosis is crucial.
• Diagnosis: Physical exam, ultrasound, blood tests for tumor markers (AFP, HCG, LDH). A radical inguinal orchiectomy is often both diagnostic (for biopsy) and therapeutic.
• Prostate Cancer: Bilateral orchiectomy (removal of both testicles) is a form of androgen deprivation therapy (ADT).
• Purpose: Reduces testosterone production, which fuels prostate cancer growth, especially in advanced or metastatic cases. It offers rapid and sustained testosterone suppression.
• Gender-Affirming Surgery: For transgender women, orchiectomy reduces endogenous testosterone production, aiding feminization and often allowing for reduced doses of hormone blockers.
• Other Reasons: Severe testicular trauma, infection not responding to treatment, or testicular torsion if the testicle is no longer viable.

Common Surgical Techniques in Korea

Orchiectomy procedures in Korea vary based on the indication, aiming for optimal outcomes.

• Radical Inguinal Orchiectomy:
• For Testicular Cancer: The standard approach. An incision is made in the groin, and the testicle and spermatic cord are removed through this incision. This method prevents potential spread of cancer cells into the scrotum.
• Simple Orchiectomy:
• For Prostate Cancer / Gender Affirming: Typically involves a scrotal incision to remove the testicle(s). In prostate cancer, a subcapsular orchiectomy (removing only the glandular tissue) may be performed to maintain scrotal appearance while achieving hormonal effect.
• Bilateral Orchiectomy: Removal of both testicles, commonly for advanced prostate cancer or gender affirmation.

Recovery & Considerations in Korea

Recovery from orchiectomy is generally straightforward, but specific considerations apply.

• Hospital Stay: Often an outpatient procedure, or a short hospital stay (1-2 days).
• Pain Management: Mild to moderate pain managed with medication. Scrotal swelling is common and typically resolves within weeks.
• Activity Restrictions: Avoid strenuous activities, heavy lifting, and bathing/swimming for several weeks.
• Hormonal Changes: Bilateral orchiectomy results in a significant drop in testosterone, leading to potential side effects like hot flashes, reduced libido, mood changes, and bone density loss. Hormone replacement therapy (e.g., estrogen for gender-affirming patients, or testosterone for prostate cancer patients if appropriate) is often managed to address these.
• Psychological Impact: Counseling and support are important, especially regarding body image and identity. Testicular prostheses are an option for cosmetic purposes.
• Infertility: Bilateral orchiectomy causes permanent infertility, necessitating discussions about fertility preservation (e.g., sperm banking) beforehand.

Korean Guidelines & Practice

Korean medical practice for orchiectomy is highly specialized and patient-focused.

• Multidisciplinary Teams: For cancer cases, urologists work with oncologists to determine the best overall treatment plan.
• Patient Counseling: Comprehensive discussions regarding the type of orchiectomy, expected outcomes, potential side effects, and post-operative management are standard.
• Prosthesis Options: Patients can discuss the option of saline or silicone testicular implants for cosmetic purposes.
• National Health Insurance: Procedures performed for medical necessity (e.g., cancer) are typically covered by the national health insurance.

Key Takeaways for Orchiectomy in Korea

To summarize the essential points about Orchiectomy in Korea:

• Purposeful Surgery: Performed for testicular cancer, prostate cancer hormone therapy, or gender affirmation.
• Specific Techniques: Radical inguinal for cancer, simple or subcapsular for other indications.
• Manages Hormonal Impact: Addresses the effects of testosterone reduction, often with hormone therapy.
• Comprehensive Care: Includes pre-surgical counseling, surgical expertise, and post-operative support for physical and emotional well-being.

We hope this guide clarifies Orchiectomy in Korea. Always consult a qualified medical professional for personalized advice, diagnosis, and treatment.