Mental health after orchiectomy: Systematic review and strategic management

Abstract

Orchiectomy, the surgical removal of one or both testicles, is often a life-changing procedure. While it is a critical treatment step for conditions such as testicular cancer, advanced prostate cancer, severe unresolving infection, trauma and gender dysphoria, the associated psychological challenges remain underexplored. Depression, anxiety, body image concerns, and diminished quality of life are prevalent but insufficiently addressed. This review synthesizes available literature to quantify these psychological impacts, explore cultural and demographic influences, and present evidence-based management strategies. The review highlights the importance of pre-operative counselling, testosterone replacement therapy (TRT), cognitive behavioural therapy (CBT), and social support networks. Future research should focus on longitudinal assessments to better understand long-term mental health outcomes post-orchiectomy.