Generally speaking, if your doctor is suspicious that there's a solid mass in the testicle, surgical removal of the entire testicle is indicated. While you might think that the incision or cut that the surgeon would make would be in the scrotum or the sack of skin where the testicle lives, a different approach is taken. A small incision in the groin, called an inguinal incision, similar to an incision that would be made to repair a hernia, is done to access the testicle from above. The reason for this is that an incision in the scrotum disrupts the lymphatic flow from the testicle and can alter the pathways of escape of the cancer. So a groin incision is always done to remove the testicle when testicular cancer is present.
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