Type of Surgery

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Last updated: 02/17/2009

Demographics

Cancer

Cancers in men vary widely in terms of both the numbers of men affected and the age groups most likely to be involved. Prostate cancer is the single most common malignancy affecting American men over the age of 50; about 220,000...

cases are reported each year. According to the Centers for Disease Control and Prevention (CDC), 31,000 men in the United States die every year from prostate cancer. African-American men are almost 70% more likely to develop prostate cancer than either Caucasian or Asian-American men; the reasons for this difference are not yet known. Other factors that increase a man's risk of developing prostate cancer include a diet high in red meat, fat, and dairy products, and a family history of the disease. Men whose father or brother(s) had prostate cancer are twice as likely as other men to develop the disease themselves. Today, however, there are still no genetic tests available for prostate cancer.

Testicular cancer, on the other hand, frequently occurs in younger men; in fact, it is the most common cancer diagnosed in males between the ages of 15 and 34. The rate of new cases in the United States each year is about 3.7 per 100,000 people. The incidence of testicular cancer has been rising in the developed countries at a rate of about 2% per year since 1970. It is not yet known whether this increase is a simple reflection of improved diagnostic techniques or whether there are other causes. There is some variation among racial and ethnic groups, with men of Scandinavian background having higher than average rates of testicular cancer, and African-American men having a lower than average incidence. Testicular cancer occurs most often in males in one of three age groups: boys 10 years old or younger; adult males between the ages of 20 and 40; and men over 60.

Other risk factors for testicular cancer include:

  • Cryptorchidism, which is a condition in which a boy's testicles do not move down from the abdomen into the scrotum at the usual point in fetal development. It is also called undescended testicle(s). Ordinarily, the testicles descend before the baby is born; however, if the baby is born prematurely, the scrotal sac may be empty at the time of delivery. About 3–4% of full-term male infants are born with undescended testicles. Men with a history of childhood cryptorchidism are three to 14 times more likely to develop testicular cancer.
  • Family history of testicular cancer.
  • A mother who took diethylstilbestrol (DES) during pregnancy. DES is a synthetic hormone that was prescribed for many women between 1938 and 1971 to prevent miscarriage. It has since been found to increase the risk of certain types of cancer in the offspring of these women.
  • Occupational and environmental factors. Separate groups of researchers in Germany and New Zealand reported in 2003 that firefighters have an elevated risk of testicular cancer compared to control subjects. The specific environmental trigger is not yet known.

Gender reassignment

Statistics for orchiectomies in connection with gender reassignment surgery are difficult to establish because most patients who have had this type of surgery prefer to keep it confidential. Persons undergoing the hormonal treatments and periods of real-life experience as members of the other sex that are required prior to genital surgery frequently report social rejection, job discrimination, and other negative consequences of their decision. Because of widespread social disapproval of surgical gender reassignment, researchers do not know the true prevalence of gender identity disorders in the general population. Early estimates were 1:37,000 males and 1:107,000 females. A recent study in the Netherlands, however, maintains that a more accurate estimation is 1:11,900 males and 1:30,400 females. In any case, the number of surgical procedures is lower than the number of patients diagnosed with gender identity disorders.


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Inguinal orchiectomy is a relatively minor surgical procedure to remove a testicle. The procedure is generally performed by a urologist. Often it is performed as same-day surgery, with the patient returning home within hours of the procedure. Some patients elect to have a prosthetic testicle inserted into their scrotum.

A 6cm incision is made above the pubic bone on the side corresponding to the testicle to be removed. The testicle is then pulled up through the inguinal canal, the spermatic cord is clamped off in two places and cut between the clamps.

The inguinal orchiectomy is a necessary procedure if testicular cancer is suspected.

If the orchiectomy is performed to diagnose cancer, the testicle and spermatic cord are then sent to a pathologist to determine the makeup of the tumor, and the extent of spread within the testicle and cord.

The pathology report, along with pre-surgical imaging studies and tumor markers, will determine the course of treatment.


From http://en.wikipedia.org/wiki/Inguinal_orchiectomy

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