Susan's Place Transgender Resources

Community Conversation => Transitioning => Orchiectomy and Penectomy => Topic started by: Lucy Ross on July 19, 2018, 08:52:57 PM

Title: Orchi types/costs
Post by: Lucy Ross on July 19, 2018, 08:52:57 PM
At my consultation with a local urologist I was surprised that she considered a basic orchi acceptable for GCS, I was under the impression that the inguinal approach was necessary if I wanted bottom work down the road, but she assured me that docs don't consider it a big deal if done well, including our local surgeon, who's about the only one I'll probably be able to work with anyway, considering my financial outlook.  Are other surgeons blase about this as well?

Is the basic procedure much cheaper?  I've read and talked to people here in Oregon who paid out-of-pocket expenses as low as $100.  My insurance has a cost calculator but it doesn't include orchi, things that seem comparable like "Urinary incontinence repair, inpatient" (for women) all seem to run around $1,500, which makes me think I should just wait a couple of years for GCS - our doc has a very long wait time.  I haven't met my deductible yet, though.  My insurance has a trans friendly caseworker I need to consult about all this stuff, too.
Title: Re: Orchi types/costs
Post by: christinej78 on October 22, 2018, 10:15:40 AM
Quote from: Lucy Ross on July 19, 2018, 08:52:57 PM
At my consultation with a local urologist I was surprised that she considered a basic orchi acceptable for GCS, I was under the impression that the inguinal approach was necessary if I wanted bottom work down the road, but she assured me that docs don't consider it a big deal if done well, including our local surgeon, who's about the only one I'll probably be able to work with anyway, considering my financial outlook.  Are other surgeons blase about this as well?

Is the basic procedure much cheaper?  I've read and talked to people here in Oregon who paid out-of-pocket expenses as low as $100.  My insurance has a cost calculator but it doesn't include orchi, things that seem comparable like "Urinary incontinence repair, inpatient" (for women) all seem to run around $1,500, which makes me think I should just wait a couple of years for GCS - our doc has a very long wait time.  I haven't met my deductible yet, though.  My insurance has a trans friendly caseworker I need to consult about all this stuff, too.

Hi Lucy,                     22 October 2018

Had my Bi lateral Inguinal radical orchiectomy Friday 13 April 2018. Cost was $3500.00 out of pocket which included everything. My insurance wouldn't cover it. The inguinal is the least traumatic of the orchie options. In my opinion the simple is the worst choice as it causes a lot of bruising and swelling. I had no pain, only minor discomfort for two days (6 Tylenol took care of it) and tiny scars about an inch long over the inguinal canals. Find Devlyn's orchie thread; I think it will validate what I have mentioned here.

Best Always, Love
Christine
Title: Re: Orchi types/costs
Post by: Lucy Ross on October 22, 2018, 10:39:01 AM
Wow, 3 months to get one reply.  Popular topic, it seems.  Thanks for responding, Christine!

When he and Dr. Ley were in town a couple of weeks ago I asked Toby Meltzer whether the basic style would be deleterious to the scrotal skin if used for GCS, and he said it wouldn't, if done properly.  He also says he's been performing these surgeries longer than anyone else in the world, excepting whichever Thai is the Granddaddy of them all.  No one I've spoken to has said anything about the basic variety involving a ton of swelling; the inguinal variety is so much more invasive I'd really rather not bother if at all possible.  My urologist has an impressive CV and came recommended by other transwomen, too.  Some people who've had the basic variety done were up and around the next day, a bit sore maybe; the conclusion I came to with this was that YMMV, like with so many other kinds of surgery.
Title: Re: Orchi types/costs
Post by: Devlyn on October 22, 2018, 10:52:48 AM
I apologize, I missed your post. I try to answer all the orchiectomy threads. My surgeon assured me that full GRS after orchi was no trouble due to the elasticity of the tissues. Think erections, and the difference between cold and warm weather testicles. I also highly recommend finding my thread as Christine mentioned. In the end I'm quite satisfied, but everyone should be aware that it isn't always a cake walk.

Hugs, Devlyn

PS My thread. https://www.susans.org/forums/index.php/topic,224375.0.html
Title: Re: Orchi types/costs
Post by: christinej78 on October 22, 2018, 11:36:38 AM
Quote from: Lucy Ross on October 22, 2018, 10:39:01 AM
Wow, 3 months to get one reply.  Popular topic, it seems.  Thanks for responding, Christine!

When he and Dr. Ley were in town a couple of weeks ago I asked Toby Meltzer whether the basic style would be deleterious to the scrotal skin if used for GCS, and he said it wouldn't, if done properly.  He also says he's been performing these surgeries longer than anyone else in the world, excepting whichever Thai is the Granddaddy of them all.  No one I've spoken to has said anything about the basic variety involving a ton of swelling; the inguinal variety is so much more invasive I'd really rather not bother if at all possible.  My urologist has an impressive CV and came recommended by other transwomen, too.  Some people who've had the basic variety done were up and around the next day, a bit sore maybe; the conclusion I came to with this was that YMMV, like with so many other kinds of surgery.

Hi Again,                  22 October 2018

I hope I didn't scare you with my description of my orchie. What I had was the least invasive of the three types normally done. The term "radical" only means they remove all of the spermatic cord. I was up the same day and pain free, only minor discomfort for two days that Tylenol took care of. I was back doing heavy work after a week and a half. My scars are almost invisible now. The doctor I had do mine is Dr. Peter Raphael in Plano, Texas. Many folks fly into Dallas to have him do their surgery. My actual cost was $3325.00 due to a 5% military discount they give to all vets and active duty military. That fee included everything, pre op (2 @), surgery suite, anesthesia, three post ops, the whole nine yards. I saw him the first time on 09 April for my first pre op consultation, 11 April for my actual Pre op checkup and Friday 13 April 2018 for the surgery. One thing they won't do is let you take them home with you. Believe me, I tried. I do have photos of it (surgery) and the testicles themselves. One last comment and I'm done: My only regret is that I didn't do it much sooner; I started HRT sans AA's approximately 16 days prior to my surgery and now I am happier than I have ever been in the 78 orbits I've made riding Spaceship Earth.

Let me also add that Devlyn's Orchie thread made my decision easier and allowed me to plan my transition path.

Hope this helps.

Best Always, Love
Christine
Title: Re: Orchi types/costs
Post by: Devlyn on October 22, 2018, 11:42:45 AM
That's why I documented the whole thing, to help others. I had no idea what was going to happen, but I'm still glad I documented it.
Title: Re: Orchi types/costs
Post by: Linde on October 22, 2018, 11:48:24 AM
I am a androgynous person, who is on the way to become a female.  My testicles are more or less decorative (it one can ever call these things decorative), but they tend to hurt a lot, because they are always in the way when I don't watch how I sit down, etc.  I talked about this with my psychologist, and she told me that all the surgeons in this area do not just remove them if one wants to have reassignment surgery later.  They want to leave everything don there untouched for this SRS at a later date.
I feel that I need to run around with hurting "balls" for many more years, because my insurance pays for in state procedures only!
Title: Re: Orchi types/costs
Post by: christinej78 on October 22, 2018, 12:11:41 PM
Quote from: Devlyn on October 22, 2018, 11:42:45 AM
That's why I documented the whole thing, to help others. I had no idea what was going to happen, but I'm still glad I documented it.

Hi Devlyn,                    22 October 2018

"I had no idea what was going to happen, but I'm still glad I documented it."

You and me both. I can't thank you enough for your Orchie thread; it made my transition so much easier. I didn't know much about transition and orchie's when I found your thread, but I sure do know a lot more now. I wouldn't go back for a $million; when I think of how happy I now am and all the problems testosterone and those two things caused me, my only wish is that I would have done it years sooner. But, I still have a lot of years ahead of me and I now have one "Fantastic" reason to move "Westward," which is where my heart and soul are.

Take care mi amiga.

Best Always, Love
Christine