orchiectomy

Orchiectomy is mainly used for testicular tumors. Oral resection can also be performed if the testicular is seriously damaged due to other reasons. Testicular tumors undergo orchiectomy, first the spermatic cord is ligated at a high position near the inner ring, and then the tumor testicular resection is performed. When the testicular resection is performed due to other lesions or injuries, the spermatic cord can be cut at a low position and the testicle can be removed. Treatment of diseases: testicular cancer Indication Orchiectomy applies to: 1. Testicular tumor or scrotum content of other malignant tumors. 2. Adult high cryptorchidism and testicular atrophy, or can not be lowered in the scrotum. 3. Severe testicular injury, which cannot be preserved after surgical exploration. 4. The spermatic cord twist causes the testicle to be necrotic. 5. Late epididymal testicular tuberculosis, resulting in testicular can not be retained. 6. Suppurative epididymal orchitis, repeated attacks, causing testicular tissue necrosis. 7. Old hematomas of the testicular sheath, causing testicular atrophy. 8. Other diseases need to be treated by castration, such as prostate cancer, bilateral testicular resection, a small part of benign prostatic hyperplasia, and even bilateral testicular excision. Preoperative preparation 1. If the epididymal testicular tuberculosis, anti-spasm treatment should be more than 1 week before surgery; if it is suppurative epididymal orchitis, anti-infective treatment should also be performed before surgery. 2. Shave the pubic hair 1 day before surgery. Surgical procedure 1. Incision: A patient who has been diagnosed as a testicular tumor before surgery. The incision is incision in the inguinal region. The upper end is in the inner ring of the inguinal region, and the lower end is extended downward along the spermatic cord, generally reaching the upper part of the scrotum. Non-testicular tumor patients with scrotal upper incision; bilateral non-neoplastic testicular resection can also use the scrotum median incision. If the preoperative diagnosis fails to determine the nature of testicular lesions, a high scrotal incision can be used. 2. Separation of spermatic cord: If it is a testicular tumor, the skin, subcutaneous and extra-abdominal oblique aponeurosis are incision through the inguinal incision, the intra-abdominal oblique muscle is pulled, and the spermatic cord is separated until the inner ring of the inguinal region. The vas deferens were separated, ligated, and cut off slightly under the inner ring. Then the vascular clamp was used to clamp and cut the spermatic vessels. The 4th wire was ligated and sutured at the proximal end to prevent vascular slippage. 3. Excision of the testicle: the distal spermatic cord is pulled upward, and the distal spermatic cord is inserted into the scrotum with fingers, and is separated outside the sheath of the testicular wall layer. Care should be taken not to squeeze the testicles, it is best to use sharp separation. Pull the contents of the scrotum out of the incision, clamp, cut and ligation the testicular band at the bottom of the testicle. Finally, all the contents of the scrotum such as testes, epididymis and spermatic cord are taken out. If the tumor adheres to the surrounding tissue, the part of the scrotum should be removed together. 4. Drainage and suturing: After completely stopping bleeding, make another small incision at the bottom of the scrotum, put it into the rubber sheet for drainage, and then suture the incision. The bleb of the external oblique muscle was sutured intermittently with a 4th wire, and the incision was sutured with a thin wire. complication 1. Bleeding: It is caused by rough operation and incomplete hemostasis during operation. Small hemorrhage in the scrotum is treated by patency or drainage of blood, scrotum cold compress and pressurization. If the wound drain has blood flow or the scrotum progressively increases, the suture should be removed, the hematoma should be removed, the bleeding should be completely stopped and the drainage strip placed. 2. Infection: Most cases are caused by chronic infection of the scrotal skin, unclean skin, less disinfection, more intraoperative tissue damage, no drainage or poor drainage, and improper postoperative care. After the infection occurs, anti-infective treatment, local hot compress or other physical therapy should be strengthened, and the circulation should be kept smooth. If an abscess is formed, the drainage should be cut open.

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