Orchiectomy during herniorrhaphy: what should we tell the patient?

Although orchiectomy is rarely required during inguinal herniorrhaphy, it is frequently a topic of preoperative concern. Our study disclosed a concomitant orchiectomy rate of 2 percent during 1,817 groin herniorrhaphies. The risk of orchiectomy was greatest in patients with incarceration (relative risk 22 times) but was also increased by herniorrhaphy for recurrence (relative risk 8 times) (Table II). On the other hand, patients undergoing repair of a primary reducible hernia were at low risk. Of the 29 patients undergoing orchiectomy, only 12 of the procedures were performed for specifically recorded testicular or spermatic cord abnormalities. The precise reason for orchiectomy was often not stated or was vague. We conclude that orchiectomy is more likely to be associated with repair of complicated hernias and that permission for possible orchiectomy should be obtained from these patients preoperatively. On the other hand, consent for orchiectomy and detailed discussion is unwarranted for patients with primary reducible hernias. In addition, orchiectomy during herniorrhaphy should be limited to cases of specific testicular and cord abnormalities, and the reason for orchiectomy should be clearly documented in the operative record.