Losing a testicle, medically termed an orchiectomy, is most commonly performed to address testicular cancer, severe trauma, or testicular torsion. The surgery is often used to diagnose cancer. Following the removal of one testicle, the human body demonstrates a considerable capacity for functional adaptation. Understanding the physical and psychological adjustments that follow this surgery provides clarity for those facing the procedure.
Surgical Context and Recovery
The surgical removal of a testicle is typically conducted through an incision in the groin, known as a radical inguinal orchiectomy, especially when cancer is suspected. This approach removes the entire spermatic cord, minimizing the risk of cancer cells spreading. Most patients manage mild to moderate discomfort for one to two weeks, often requiring prescription pain medication initially.
Swelling and bruising in the scrotum are common and generally subside within two to four weeks. Physical activity is restricted during recovery; surgeons advise against heavy lifting or strenuous exercise for at least two to three weeks to allow the wound to heal properly. Patients should avoid driving for one to two weeks and refrain from taking baths for two weeks, though showering is permitted after two days.
Hormonal Balance and Compensation
The testicles are the main site of male hormone production, but the remaining testicle compensates for the loss of its partner. In most cases, the single remaining testicle increases its output to maintain systemic hormone levels within the normal range.
This compensatory mechanism is driven by the pituitary gland, which releases higher levels of Luteinizing Hormone (LH) to stimulate the remaining testicle. The elevated LH signals the testicle to ramp up testosterone production, maintaining hormonal balance. Monitoring testosterone levels post-procedure confirms successful compensation.
A small subset of men may not achieve full compensation, leading to hypogonadism, or low testosterone. Symptoms include decreased libido, fatigue, loss of muscle mass, or reduced bone density. If blood tests confirm a persistent deficiency, Testosterone Replacement Therapy (TRT) is an effective treatment option. TRT involves administering external testosterone via injections, gels, or patches to restore levels and alleviate symptoms.
Fertility and Reproductive Capacity
One healthy testicle is generally sufficient to maintain reproductive capacity. While the total volume of sperm produced may reduce, the remaining testicle typically produces enough viable sperm for conception. Paternity rates following unilateral orchiectomy are favorable, approaching 90% in men with a normal contralateral testicle.
The fertility landscape is more complex when orchiectomy is performed due to cancer, as many men with testicular cancer may have pre-existing issues impairing sperm quality. Therefore, a semen analysis is often recommended before the procedure to assess sperm count and motility.
If the remaining testicle is compromised or if further treatments like chemotherapy or radiation are anticipated, sperm banking preserves future reproductive potential. This involves cryopreserving sperm for later use in assisted reproductive technologies. Counseling about fertility preservation ensures patients make informed decisions about family planning.
Long-Term Physical and Emotional Adjustments
Long-term adjustment involves emotional and body image considerations. For some men, the loss of a testicle is associated with feelings of loss, shame, or a perceived impact on masculinity, despite preserved function. Open discussion with partners about these feelings aids the healing process.
To address the physical change, a testicular prosthetic, or implant, is available and can be placed during the orchiectomy or later. This cosmetic solution is designed to mimic the feel and appearance of the natural testicle. Studies indicate that while a prosthesis does not directly affect sexual function, it can reduce feelings of loss and uneasiness regarding body image.
For those who experience persistent anxiety, depression, or difficulty adjusting, seeking psychological support is recommended. Healthcare providers can recommend specialized counselors or support groups where men can share experiences. Most men successfully adapt to life with one testicle, maintaining a normal quality of life, sexual function, and hormonal profile.