Why surgeons often cut through the groin rather than the scrotum

Society · Published 11 October 2026 Swipe more like this →

In short: When treating testicular cancer, the first step is almost always a radical inguinal orchiectomy. Instead of an incision in the scrotum, surgeons use a groin incision—similar to a hernia operation—to access the spermatic cord and remove the testicle to prevent the cancer from spreading.

The standard initial procedure for testicular cancer is a radical inguinal orchiectomy. The term 'radical' indicates the surgery is performed to diagnose the cancer, while 'inguinal' refers to the incision made in the groin area rather than the scrotum. This approach allows surgeons to access the spermatic cord, a structure containing blood vessels and the vas deferens, which carries sperm from the testicle. To minimize the risk of cancer spreading through these pathways, surgeons perform a high ligation, where they tie off and divide the cord at a high level before removing the testicle.

The pathology of the removed tissue is vital; a pathologist evaluates the testicle to determine the specific cancer type and its extent. This diagnosis dictates whether further treatment is required. While surgery may be the only necessary intervention, patients may also require chemotherapy, radiotherapy, or surveillance through imaging. In cases where the disease has spread to the abdominal area, urologists may perform a retroperitoneal lymph node dissection. This major operation involves entering the abdominal cavity to remove lymph nodes located around the aorta—the body's largest artery—and the vena cava, the body's largest vein.

Treatment complexity increases if the cancer has spread to other organs, such as the lungs, which may require the assistance of thoracic surgeons. While most patients undergo a full orchiectomy, some may undergo a partial orchiectomy (testis-sparing surgery) to preserve hormone function and fertility, though this is not the standard approach. It is also worth noting that while cancer can occur in both testicles, this is rare, affecting approximately 2% of people with testicular cancer. In such instances, a bilateral orchiectomy is typically required.

General information, not professional advice. Spotted an error? Flag the card or see corrections and complaints.

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