likely to have a stage 1 diagnosis and the individual must undergo surveillance every 3–6 months in the first year following their orchiectomy, with an abdominal/pelvic ct at 3, 6 and 12 months. additional treatment such as chemotherapy may be given if they have risk factors for a relapse. men with stage 1 seminoma after orchiectomy have been shown to be free from a relapse for five years following orchiectomy. orchiectomy as a complication of testicular torsion among children and adolescents diagnosed with testicular torsion, the orchiectomy rate is as high as 42%. though the goal during surgery is to correct the twist of the spermatic cord, orchiectomy is performed if the testicle is examined during the surgery to have dead tissue (necrosis) and suspected to no longer be a functioning testicle (no fertility). delays in diagnosis and treatment increase the risk of orchiectomy, with diagnosis in the first four to eight hours of symptoms being critical to prevent permanent ischemic damage, decreased fertility, and need for orchiectomy. orchiectomy for prostate cancer prostate cancer, if non-metastatic, is commonly treated with radical prostatectomy or radiation therapy. less often, orchiectomy is used to treat prostate cancer. prostate cancer grows in the presence of testosterone. when testosterone is present, " it is metabolized and converted into dihydrotestosterone (dht) which stimulates the growth of prostate cells. this leads to normal prostate growth in adolescents but contributes to abnormal cell growth in older men." reducing the amount of testosterone in a person is one way in which prostate cancer is treated. if the prostate cancer is in fact metastatic, then orchiectomy may be used "...to abolish the stimulation of cancer cells by inhibiting testicular testosterone production and thereby reducing androgen levels in the blood: so-called androgen deprivation therapy (adt)." castration or orchiectomy is a suitable option for androgen deprivation therapy, and it should be used if a very quick reduction in testosterone levels is needed. however, in recent years, orchiectomy is not commonly used since medical castration is a viable option. medical castration means that drugs or medications are used to suppress the production of androgens such as testosterone. some examples of medications used in medical castration include, euprolide, goserelin (zoladex), buserelin, and triptorelin (trelstar). some of the side effects of these medications include but are not limited to "reduced sexual desire and libido, impotence, reduced size of testes and penis, hot flashes, growth of breast tissue (gynaecomastia) and pain across the breasts, thinning of the bones or osteoporosis and risk of fracture, anemia, loss of muscle mass, weight gain, fatigue and memory problems, and depression." orchiectomy for pediatric testis tumors until the mid-1980s, pediatric testis tumors were managed in accordance with adult guidelines where the standard therapy was radical inguinal orchiectomy. it was later discovered that this procedure was being overused in the pediatric population, particularly those in pre-puberty, because it was assumed that the tumor was malignant. it was discovered that the majority of the pediatric tumor registries over reported malignant tumors and had biased reporting. it has now been found that most tumors are benign lesions and the majority are cases of teratoma which act benign in pre-puberty pediatric individuals along with other benign tumors that have been reported such as: sertolic cell tumor, leydig cell tumor and juvenile granulosa cell tumors. most malignant tumors found in pre-pubertal individuals are pure yolk sac tumors. there is a difference in pre-pubertal, post-pubertal, and adult testis tumors in their histology and their level of malignancy with malignant tumors being rare in the pre-pubertal pediatric population. there has been a consideration to switch to testes sparing surgery (tss) such as partial orchiectomy specifically for the pre-puberty pediatric populations who lack signs of malignant tumors. partial orchiectomy allows the ability to preserve hormone function and the possibility of reproduction in the future. it has also been found to increase the quality of life. in the case that an individual is pediatric (<18 years of age) and is a post-pubertal with a malignant testes tumor, they must follow the adult recommended standard guidelines and proceed with radical inguinal orchiectomy. post-pubertal populations the post-pubertal pediatric population and adults are at higher risk of malignant tumors and usually have a histology of a mixed germ cell tumor. their first line of treatment is radical orchiectomy; however, they may be candidates for testis-sparing surgery such as partial orchiectomy, if there is a presence of a benign tumor. although partial orchiectomy is controversial for this group of individuals, it has been found to be a successful procedure for benign masses such as stromal tumors, epidermoid cysts, and fibrous pseudotumors. there is greater use of partial orchiectomy with individuals who have small, benign testicular mass usually < 2 cm which indicate the tumors being benign. there is limited data on the size of tumors of the pediatric population, therefore, size cannot be used as a predictor of a tumor being benign.