Decline in bilateral orchiectomy for prostate cancer in Olmsted County, Minnesota, 1956-2000

Objective: To assess long-term secular trends in the utilization of bilater al compared with unilateral orchiectomy in the community. Patients and Methods: This population-based descriptive study reviewed medi cal records of all Olmsted County, Minnesota, men undergoing orchiectomy be tween 1956 and 2000. Results: Over the 45-year study period, 381 Olmsted County men had a first unilateral orchiectomy, while 431 underwent bilateral orchiectomy (includin g 8 with a second unilateral orchiectomy). There was no change over time in the age-adjusted utilization of unilateral orchiectomy, which was performe d for a wide range of indications, mostly cryptorchidisim and testicular ma lignancy. Most bilateral procedures, on the other hand, were in elderly men for castration, and trends over time generally paralleled those reported f or prostate cancer in this community. Conclusion: The declining incidence of prostate cancer in recent years, com bined with a shift to earlier stages and younger ages at diagnosis, and the development of pharmacological approaches to hormonal manipulation have le d to a dramatic decline in the utilization of bilateral orchiectomy, while unilateral orchiectomy rates have remained unchanged.