Effects of total and subcapsular orchidectomy on serum concentrations of testosterone and pituitary hormones in patients with carcinoma of the prostate.

22 men with carcinoma of the prostate were consecutively subjected to either total or subcapsular orchidectomy at random. Serum concentrations of testosterone, follicle-stimulating hormone, luteinizing hormone, prolactin, thyroid-stimulating hormone and testosterone-estrogen-binding globulin were followed. No differences were found between the two groups during the 6-month follow-up period. Orchidectomy reduced testosterone concentration in all cases and none responded to human chorionic gonadotrophin stimulation 6 months postoperatively. The concentrations of free and bound testosterone were calculated but did not vary between the two types of operation, which were considered equally efficient in reducing testosterone concentration. However, doubts about the completeness of the operation might possibly arise in cases with cancer progress and therefore we prefer total orchidectomy as the first choice, but perform subtotal orchidectomy on those men preferring this type of operation psychologically.