Does it really matter which orchiectomy method is used??

[Belladona]

I realise that I probably won't get an answer in time, I'm booked in for surgery in like 17 hours...
The urologist that is doing my orchiectomy told me back when I had the consultation that he was aware that there is a certain method used for transgender patients and he would look into it.
The hospital rang me before Christmas to say there was an opening on 18th January, I didn't think I'd get seen so soon!
I phoned the hospital the other week to get more details and found out the urologist was on leave and he would contact me when he gets back. So I get a phone call yesterday and the urologist said that he was looking at doing the simple orchiectomy apparently it shouldn't matter which method is used?? He said the inguinal method has two incisions and there is no medical reason to do that over the simple method of going through the scrotum, which only requires one incision. He went on to say if I get SRS in the future they just cut the scrotum in the same place so it doesn't matter if I get the orchiectomy done the simple way.

I'm a bit confused cause there is information floating around the internet saying the inguinal method is better because it leaves vital skin intact that is needed for future surgery. There seems to be conflicting information on this. Am I worrying over nothing??
I'd rather have the inguinal I feel that would be easier to heal and more convenient for me as I wear tight clothes. In a way I feel that the simple method is actually more invasive and I would have more emotional strain. Am I going to be worse off getting the simple orchiectomy over inguinal? It sounds like I'm not going to be able to get it done the way I want  I guess I can't really argue my case when I'm getting it done for free...

[Belladona]

I'm in recovery, its hell. I did end up going ingiunal, I have mixed feelings because of the pain I'm in. I am glad I don't have a cut on my scrotum, I haven't had a proper feel yet, I'm still in agony. I had my urine bag removed this morning, that was quite traumatic.
As well as the orchiectomy I had a camera put into my urine track, I've been having bladder problems for quite a while. They found scar tissue obstructing so the inside of my urine track got stretched thats why I had to have a urine bag for a day because possible swelling could stop me passing urine.
I was told the obstruction couldn't be removed easily and that it could stop me getting further surgery down there. Its still sinking in that I have a permanent condition and need to get everything stretched and having a urine bag again. I'm actually okay about having a bag attached just not a tube tube going into my wee wee, especially after the inside has been stretched and bleeding.

I might write some more later about why I had my orchiectomy done, no point me talking about recovery its empty words going in a void that doesn't want to know

[AnneK]

I had a camera put into my urine track

Did you see the inside of your bladder on TV?  I had the same thing on Tuesday and also a while ago. 

[Belladona]

They did both procedures while I was under the anesthetic so no TV for me.. I probably wouldn't have been able to watch even if I was awake I've got too much trauma with my all my bits down there.
I think I'm going to take quite a while to heal from this

[AnneK]

They did both procedures while I was under the anesthetic so no TV for me.. I probably wouldn't have been able to watch even if I was awake

Well, maybe it'll be on YouTube.   

[AshleyP]

I'm praying for your speedy recovery and successful resolution to any issues that may have been uncovered. Hang in there, girl. The worst usually passes pretty quickly.

I also would be interested in your reasoning behind the switch in procedures. I've done some reading on the subject, and when I first saw your inquiry I thought about suggesting that you research the inguinal procedure more, as it seems to me to be the preferred method. However, my research is only anecdotal and I have no first hand knowledge, hence my reluctance.

All the best,
--AshleyP

[Linde]

Did you see the inside of your bladder on TV?  I had the same thing on Tuesday and also a while ago.

I did a few years ago.  I try to stay awake for any medical/surgical procedure, if possible, because I want to observe what they are doing with and to me.

[AnneK]

I did a few years ago.  I try to stay awake for any medical/surgical procedure, if possible, because I want to observe what they are doing with and to me.

And hear when the doctor says "oops".   

[Linde]

And hear when the doctor says "oops".   

I would have asked: Whats App?
In honest, I want to see when people of my profession work on my body.  Prior to any cutting, i want to see the appropriate steril presentation of the instruments to be used.  As well as the sterilization indicator of the batch.  I tell this at the presurgical, and they can prepare for it.

[GingerVicki]

I did a few years ago.  I try to stay awake for any medical/surgical procedure, if possible, because I want to observe what they are doing with and to me.

I was awake when I had my vasectomy. kinda gross. I want to watch the boys go. Kinda some sick closure. 

[Linde]

I was awake when I had my vasectomy. kinda gross. I want to watch the boys go. Kinda some sick closure. 

Did you wave goodbye, and made sure they were dressed appropriately?

[GingerVicki]

Did you wave goodbye, and made sure they were dressed appropriately?

I did not wave, but I was smiling the entire time

[Belladona]

I'm praying for your speedy recovery and successful resolution to any issues that may have been uncovered. Hang in there, girl. The worst usually passes pretty quickly.

I also would be interested in your reasoning behind the switch in procedures. I've done some reading on the subject, and when I first saw your inquiry I thought about suggesting that you research the inguinal procedure more, as it seems to me to be the preferred method. However, my research is only anecdotal and I have no first hand knowledge, hence my reluctance.

All the best,
--AshleyP

I got to choose the ingiunal method, I'm very grateful to get it done at no cost.
The urologist told me that he contacted some places around the world like universities and surgical wards and stuff; the method preferred for transgender patients was through the scrotum, people arguing for the ingiunal method seems to be only a internet trend.
After having my orchiectomy done ingiunal I would tend to agree with medical knowledge over the internet. What I think has started the confusion:
1.Back before dissolving stitches perhaps the scars were larger and that caused trouble with the scrotal method.
2.Some places only offer ingiunal (probably for money reasons) leading patients to believe that its the superior way.
3.Maybe forums spreading misleading information to stop people from operating on themselves
4. Confusion over skin shrinkage
5. Personal choice/bias

I think my urologist was right, technically it is recommended to do an orchiectomy in the most simplest way with fewer incisions and faster healing time. There is no technical advantage between the two methods and doesn't affect SRS in the future as long as the scrotum isn't also removed. However after getting an orchiectomy there is the possibility of skin shinking, this can happen regardless of method used.
Why I chose ingiunal against my urologist was mainly because of body dysphoria and I think this factor does sway other peoples choice of method.

[GingerVicki]

I want the simple with removal of the extra skin.

[christinej78]

I got to choose the ingiunal method, I'm very grateful to get it done at no cost.
The urologist told me that he contacted some places around the world like universities and surgical wards and stuff; the method preferred for transgender patients was through the scrotum, people arguing for the ingiunal method seems to be only a internet trend.
After having my orchiectomy done ingiunal I would tend to agree with medical knowledge over the internet. What I think has started the confusion:
1.Back before dissolving stitches perhaps the scars were larger and that caused trouble with the scrotal method.
2.Some places only offer ingiunal (probably for money reasons) leading patients to believe that its the superior way.
3.Maybe forums spreading misleading information to stop people from operating on themselves
4. Confusion over skin shrinkage
5. Personal choice/bias

I think my urologist was right, technically it is recommended to do an orchiectomy in the most simplest way with fewer incisions and faster healing time. There is no technical advantage between the two methods and doesn't affect SRS in the future as long as the scrotum isn't also removed. However after getting an orchiectomy there is the possibility of skin shinking, this can happen regardless of method used.
Why I chose ingiunal against my urologist was mainly because of body dysphoria and I think this factor does sway other peoples choice of method.

Hi Belladona,                            20 January 2019

To answer the question in the title of this thread: Does it really matter which orchiectomy method is used?? The answer is: YES!!

Hope I'm not butting in here; I had my Orchiectomy Friday 13 April 2018. I had the Bilateral, Inguinal, Radical, Orchiectomy, which is what I wanted. The doctor I chose only does inguinal, which is why he was high on my list of choices. My research indicated that inguinal was the least invasive, the least traumatic and the fastest healing.

My surgery took about 35 minutes, I walked out on my own power. had no pain just minor discomfort for two days which was handled by a total of 6 Tylenol over the two days. The two incisions were about 1 to 1.5 inches in length, were sutured with dissolvable sutures with no visible thread, all done internally. They were healed in one week and I was back doing heavy duty work after a week and a half.

It's now a little over 3/4 of a year since my surgery and the scars are almost invisible; I have to look very carefully to find them.

My opinion of the simple is that it is next to the most traumatic for the patient; the Subcapsular orchiectomy, in my opinion is more traumatic than the other two, reason being more tissue is disturbed during this procedure.

If you want to see what you missed by having the inguinal instead of the simple, look for Devlyn's chronicle of her simple orchi. I think you will have a different opinion once you read it and see the pictures. I have pictures of mine, unfortunately I'm not allowed to post them here. If I were allowed they would be here for all to see.

My surgery cost $3500.00 total for, pre surgical consultation, Pre surgical checkup, surgery, anesthesia, operating room, pre and post care nurses, three post op checkups. I did receive a 5% discount off the price I quoted due to being a Veteran.

From everything I have read, the simple is performed by surgeons because it is easier for them or they do not have the necessary skill to do the Inguinal. Don't take this as gospel, it's my opinion based on my research and experience.

I'm sorry you had to have additional work done, especially within the bladder and urethra. I had a similar experience sans the Orchi, when I was 17. It wasn't a pleasant experience. Had you not needed the additional procedures, I'm sure your post surgical recovery would have been less painful and less traumatic. I have posted on this subject elsewhere on Susan's, just don't remember the threads.

Best wishes for a speedy recovery.

Best Always, Love
Christine

[Belladona]

I have read devlyn's thread, I DIDN'T GET A COOKIE 
I think maybe each method is its own healing experience. I've been in a lot of pain and almost completely bed ridden for 3 days. I really underestimated how much pain I would be in, I've needed prescription pain meds and probably going to need them for a few more days. I think I would have had a lot more mobility and less pain if I had the simple orchiectomy. At least there isn't any blood or annoying chords in my scrotum, thats a definite advantage with going ingiunal. It would be psychologically difficult for me to heal an injury on a body part I'm not comfortable having, so in that regard I'm happy with the decision I made.

[Chloe]

My surgery took about 35 minutes, I walked out on my own power.

       Christine I am confused over what the differences are in the procedures? I accompanied a member here during a orchi and her experience and recovery was easy, much like yours. I assume the connections are cut and testes removed? She probably still has hers sitting in a glass jar atop the refrigerator! 

      Personally, being 'older' and very diminutive in size to begin with, I would never do this see it as unnecessary my body has learned to live without AA's but dislike the idea of forever being totally estrogen-dependent (with a possible ultra low T deficiency?) for life. Of course SRS would be another matter entirely don't feel I'd be eligible for inversion/depth technique without extensive grafting so would prefer to wait until something more perfected comes along?

[Linde]

      Personally, being 'older' and very diminutive in size to begin with, I would never do this see it as unnecessary my body has learned to live without AA's but dislike the idea of forever being totally estrogen-dependent (with a possible ultra low T deficiency?) for life. Of course SRS would be another matter entirely don't feel I'd be eligible for inversion/depth technique without extensive grafting so would prefer to wait until something more perfected comes along?

Iam, older like you, and have only almond/hazelnut sized testes left.  My urologist is of the opinion that those babies stopped to make testosteron quite a while ago could that have been the reason that my breasts started to grow way before I ever found out about HRT?
But I will try to get them removed, because those guys hurt constantly.  I barely can touch them, and I have to always watch how I sit down to not hurt.  They tried antibiotics again, because some physicians seem not to listen and understand that patients have some knowledge, too.  I tried to explain that this is not a bacterial infection (I very likely know more about that crap than their entire office).  I now have to get it across that something else is wrong down there that ended up in some kind of chronic inflammation.  To find out what it is that is causing the pain, they would have to cu me open anyway, and at that point they may as well take the babies out for good. 
That would render me balless, and because I had part of my spine removed already (good old stainless steel instead), I would be a partially spineless and balless person, just fitting for a little old woman!

For the case that I would want to have SRS (I actually want it really badly), I would go with a minimum depth vulvoplasty any way, and would care less to have not much material for a vagina!  At my age, those parts are way overrated anyway!

[christinej78]

       Christine I am confused over what the differences are in the procedures? I accompanied a member here during a orchi and her experience and recovery was easy, much like yours. I assume the connections are cut and testes removed? She probably still has hers sitting in a glass jar atop the refrigerator! 

      Personally, being 'older' and very diminutive in size to begin with, I would never do this see it as unnecessary my body has learned to live without AA's but dislike the idea of forever being totally estrogen-dependent (with a possible ultra low T deficiency?) for life. Of course SRS would be another matter entirely don't feel I'd be eligible for inversion/depth technique without extensive grafting so would prefer to wait until something more perfected comes along?

Hi Chloe,                         21 January 2019

Here is how my Inguinal orchi was done. I went to my surgery appointment with that area completely waxed (Brazilian) and hair free. I climbed onto the surgical table under my own power and un-sedated (don't do Benzos of any stripe).

I had them raise the head of the table so I could be in a reclining position head up. I didn't want to be intubated (breathing machine), I wanted to breathe on my own. They didn't want to do it using local anesthesia as some of the stuff couldn't be numbed. I agreed to be conked out using a Propofol drip. This method puts you to sleep quickly and when they stop the drip you are awake and clear headed in minutes. None of the fog bank stuff that results from the Benzodiazepine class of drugs most doctors prefer to use. Just for information purposes, Benzos are dangerous for everyone and more so for persons of advanced age.

They opened two small incisions over the upper part of each canal about 1 to 1.5 inch long. They then pushed each testicle up the canal simultaneously (four hands involved) and popped them out through the incisions. They pulled them out and laid them on my belly above my penis, then took photos of them. They then pulled the spermatic cord out as far as they could, clamped it, tied it then severed it completely. No need for string dangling down into the scrotum. Once both were out, severed/removed they laid them on the surgical towel on my belly and photographed them again as a testament to their skill in performing Inguinal orchiectomies and as souvenirs for me. No, I didn't get to take them home with me though I did ask.

The rest I have already written about. I'm totally happy with the result and the doctors and their staff that took care of me.

Hope this helps clear up any concerns about this procedure. I had no swelling and only a tiny bit of hematoma (blood under the skin) that cleared up in a week. My scrotum has shrunk to a tiny pouch that's almost unnoticeable. Remember the scrotum is very stretchy so don't worry about it if you plan on bottom surgery at a later date, which I plan on doing after I move to Phoenix this spring. I want the cosmetic vagina, less traumatic than the full depth version. I don't have any desire to have sex with a male so why have something I won't need.

Take care and hope everyone that has this procedure has an even better outcome than I did, and mine was fantastic.

Best Always, Love
Christine 

[Chloe]

. . . a partially spineless and balless person, just fitting for a little old woman!

lol     thx to both of you think I've got a pretty good visual!

So it's a *slice, pop, clip knot & snip* am almost certain that's what Keri had as well! Dietlind sometimes I get *pinching* pain from tucking 24/7 but nothing like you describe . . . you're on "E only" too(?) been dry and inactive for so long I also highly doubt have much T left as well!

This AM ex-spousy braided my hair for the very first time if young "convicts" are gonna persist in hitting on me with def need the full-depth model!