Subinguinal Orchidectomy for Testicular Tumour: A Regional Analysis of Oncological Control and Postoperative Outcomes

IntroductionRadical inguinal orchidectomy (RIO) is the standard surgical approach to treating testicular tumours.Subinguinal orchidectomy (SIO) is a modified approach, wherein the inguinal canal is spared from exploration and the spermatic cord is ligated as close as possible to the superficial inguinal ring.Theoretically, it offers the advantage of avoiding the complications related to inguinal canal exploration whilst maintaining sufficient oncological control.However, contemporary primary data on both outcomes remain limited. MethodsThis is a retrospective single-arm study of 52 consecutive patients who underwent SIO at a tertiary urology centre from 2016 to 2025.Parameters explored included patient demographics, tumour laterality, and biochemical and histopathological staging.Primary outcomes were positive surgical margins, disease recurrence, and postoperative complications including wound infection, chronic pain, and phantom testis syndrome.Data analysis was carried out using SPSS v29 (IBM Corp., Armonk, NY). ResultsFifty-two patients were analysed (median age: 42.5 years; IQR: 31.5-58.25 years).Bilateral and synchronous tumours were each reported in one case, yielding a total of 54 oncological units for analysis, of which 44 were malignant and 10 were benign Thirty out of the 44 malignant cases were germ cell tumours (seminoma and non-seminomatous germ cell tumours) on histology (68.2%).Postoperative staging revealed nodal disease in 31% and metastatic disease in 14.3%.All surgical margins were negative.Four patients had spermatic cord involvement (SCI; 7.7%).Three patients (5.8%) developed recurrence, exclusively nodal, at a mean of 20.3 ± 13.8 months; no local or scrotal recurrence was observed.Postoperative complications occurred in 10 patients (19.2%), including Clavien-Dindo grade IIIb complications in five patients (9.6%).No chronic pain or hernia was reported.Median follow-up was 1.35 years. ConclusionSIO provided good oncological control, with no positive surgical margins, a low recurrence rate, and acceptable morbidity.These results suggest that it may provide acceptable oncological and postoperative outcomes in selected patients.