There are two surgical procedures done to treat testicular cancer: orchiectomy and retroperitoneal lymph node dissection (RPLND).

Orchiectomy

Orchiectomy is the surgical removal of the testicle. If your examination and tests are consistent with cancer, you will probably have surgery to examine the testicle directly. An incision is made in the groin and the entire testicle is removed if it appears to have cancer.

It is possible during this procedure or in a subsequent operation to place a prosthetic (fake) testicle in the scrotum to recreate a normal appearance.

Retroperitoneal Lymph Node Dissection (RPLND)

A nonseminoma cancer may have spread beyond the testis, but is likely to be confined to the lymph nodes in the area. As a result, you may have these lymph nodes surgically removed. This procedure is called a retroperitoneal lymph node dissection (RPLND).

An incision is made along your abdomen and every lymph node from your diaphragm to your anus is inspected. Any that may have cancer are removed and sent to the lab for analysis. This is major surgery, usually taking 4-6 hours or longer.

Historically, this procedure could cause significant side effects including retrograde ejaculation (ejaculation of semen back into the bladder). More recent advances in surgical techniques, however, have made these side effects much less common, but has not eliminated them entirely.