Inguinal orchidectomy and simple orchidectomy are both surgical options for the removal of one or both testicles. The main difference between the two procedures is where the incision is made.
A simple orchidectomy involves making an incision directly in the scrotum to remove the testicle(s). This procedure is often done as a day surgery, and patients typically recover quickly with minimal pain and scarring. Some of the pros of a simple orchidectomy include easier recovery and reduced risk of complications compared to an inguinal orchidectomy. Additionally, this method is often cheaper than the more complex procedure.
In contrast, an inguinal orchidectomy involves making an incision in the groin area to access the spermatic cord, which is then cut to remove the testicle(s). This procedure is more complex and may require an overnight stay in the hospital. Inguinal orchidectomy is often recommended when a patient has a large testicular tumor or other complications that require the surgeon to access the testicle(s) from a different angle. Despite the added complexity, some patients prefer this technique due to cosmetic reasons (less visible scarring) and the perception of enhanced safety (especially if they have specific risks for scrotal infection).
However, since inguinal orchidectomy is a more invasive surgery, it carries higher risks of complications such as infection, bleeding, scrotal hematoma, lymphocele, and nerve damage. Patients also experience more pain and longer recovery times compared to simple orchidectomy. The use of general anesthesia is more common when performing inguinal orchidectomy, which can contribute to more risks for some groups of patients (such as the elderly, very young, or those with heart conditions).
Ultimately, the choice between inguinal orchidectomy and simple orchidectomy will come down to the patient's medical condition, the size and positioning of the testicular tumor, the expected risk-benefit ratio, and the individual preferences of the patient and surgeon involved. Patients who require a simple orchidectomy often report quick recovery, minimal pain, and full return to daily activities within a few weeks after the surgery. On the other hand, patients who undergo an inguinal orchidectomy, while facing a longer recovery period and more noticeable scarring, may benefit from the lower risk of infection and other localized complications. As such, the best approach will depend on the individual patient's needs, goals, and overall health status.