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Bilateral Orchiectomy (for Prostate Cancer)

Removal of both testicles in advanced prostate cancer.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Üroloji department. Book Appointment →

What is Bilateral Orchiectomy (for Prostate Cancer)?

Bilateral orchiectomy (surgical castration) is the permanent cessation of testosterone production by removing both testicles in advanced or metastatic prostate cancer. Prostate cancer cells require testosterone to grow.

The procedure can be performed under local or spinal anesthesia and takes about 30-60 minutes. In the subcapsular orchiectomy technique, the testicular capsule and epididymis are preserved to maintain a more natural cosmetic appearance.

It is equivalent in efficacy to GnRH agonist or antagonist medications (medical castration), does not require monthly injections and is more cost-effective. It is preferred in patients with poor medication adherence or when urgent castration is required.

Symptoms

Diagnosis of metastatic prostate cancer
Locally advanced prostate cancer
Difficulty with adherence to GnRH therapy
Need for emergency androgen deprivation (spinal cord compression)
Inability to maintain medical castration for economic reasons
Elevated PSA together with widespread metastases

Risk Factors

Hot flashes and sweating (50-80%)
Loss of sexual function
Osteoporosis and bone fracture risk
Loss of muscle mass and metabolic syndrome
Depression and cognitive changes
Increased cardiovascular risk

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • At diagnosis of metastatic prostate cancer
  • When GnRH therapy side effects cannot be tolerated
  • When emergency castration is required (e.g. spinal cord compression)
  • Bone health and metabolic monitoring after orchiectomy

Treatment Methods

01
Bilateral subcapsular orchiectomy (cosmetic approach)
02
Bilateral simple orchiectomy
03
Testicular prosthesis implantation (optional, cosmetic)
04
Management of hot flashes (venlafaxine, gabapentin)
05
Bone density monitoring with calcium and vitamin D supplementation
06
Oncologic follow-up with regular PSA testing and imaging

Which Department to Visit?

You can visit our Üroloji department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.