Orchidectomy surgery- low sex drive

Dear Ask The Doctor: February 22 2010 I had a Radical RT orchiectomy , everything went fine. Now I am experiencing low sex drive, depression, soft erections. I can cum, but I can't get as hard as I used to. I am frustrated with my body. What Do I do?

Dear Cliff: Testosterone is the hormone responsible for the sex drive in men. The loss of a testicle does reduce the amount of hormone produced, however, the remaining testicle usually compensates for this loss and increases production of the hormone accordingly so that sexual function is unaffected. A radical orchiectomy involves not only removal of the testicle but removal of lymph nodes within the abdomen as well. This aspect of the procedure may affect the nerves responsible for sexual function. This is just one possible explanation for your symptoms. Other possibilities include Major Depression and erectile dysfunction. I suggest talking to your surgeon about these possibilities and having the appropriate examination and tests done.