Orchidectomy is the removal of testes without any attempt to refashion the genitalia. In the past, before the advent of effective anti-androgen medication this was often done (and indeed sometimes still is) to reduce the patients androgen levels and increase the effectiveness of HRT.
It is sometimes opted for by patients who need time to save money for full SRS as it reduces the need to take potentially harmful drugs to suppress the androgens. There are also some people who do not desire full reassignment surgery for whatever reason.
SRS - Sex Reassignment Surgery - can be done using a variety of methods all of which have their pros and cons.
Cosmetic SRS - Some patients opt for what is known as a cosmetic op where no attempt is made to create a workable vaginal depth. This can be carried out on patients who may be judged in too poor a state of health to undergo full SRS. It is also cheaper. However it is NOT a suitable choice for anyone who contemplates an active female sex life.
Penile Inversion - is the simplest form of vaginoplasty. Where there is sufficient skin on the original male member this is inverted and used to line the new vaginal canal. Skin from the scrotum is used to construct the labia and vulva. Where there is ample material this system has the virtue of being simple and requiring no special pre treatments (for example hair removal on the genitals)
Peno-Scrotal Graft - is a refinement of the above technique. It is said by some to give a more natural appearance of the created genitals. It also provides more material to work with, which for those not amply endowed offers the prospect of a better depth. I had an early version of this done on me.
One potential complication is that the scrotal skin needs hair removal prior to use. Unfortunately with early patients like myself this was not fully realised with the result that some of us ended up with internal hair (fortunately I didn't have much and so I don't have a huge problem, but for some girls it was a major issue.) The upshot is that these days surgeons are fairly insistent that patients undergo electrolysis on the relevant area OUCH!
A further refinement of this technique is used by surgeons like Suporn who attempt to use urethral mucosa to try and make the constructed vagina self lubricating. This can be quite successful for some people.
Colon Section - This is not so popular these days. It represents MAJOR surgery and it has a much higher risk of SERIOUS complications. In this technique a small section of colon was isolated and used to line the new vagina. Problems with odour, durability and indeed the simple fact that you have to cut and staple the intestine make this technique risky to say the least.
Donor Skin Graft - Both penile inversion and Peno-Scrotal techniques can be supplemented by taking some donor skin from the thigh or abdomen. This is now the preferred option for achieving adequate depth if there is limited material to work with.
One and Two Stage procedures.
In many respects this is a false dichotomy, as whether or not a "second stage" is needed will depend as much on the patient as it does on the surgeon. The cosmetics of the finished genitals are important to most of us. Most surgeons will attempt to produce a convincing visual effect from the first operation, but in some case, time limitations or simply the starting anatomy simply does not allow this to be done whilst also working to achieve a good depth of vagina.
In such cases, I was one such, a second stage will often be needed to construct a "pretty" and/or anatomically accurate vulva. It is only in relatively recent times that this has become more popular. Second surgery can vary in its scope. Some like me end up having a full rework of their whole vulva and urethral opening done under general anesthesia, others may only need very minor surgery, as is the case with some labiaplasty, which is sometimes done under local anesthetic in a doctors office.
The three cosmetic procedures which can be done are:
Labiaplasty - refers to the creation of well defined labia minora.
Clitoroplasty - is the creation of a sensate clitoris and hood. This is often done during vaginoplasty but it is not always so, and SOMETIMES, if it was not so done, and if enough nerve tissue remains, it is possible to attempt a "retro fit" at a later stage.
Urethral relocation - is the repositioning of the urethral opening into a more female typical position than often results from basic vaginoplasty.
I recently and somewhat belatedly underwent all three procedures successfully about a quarter of a century after my original SRS op.
This is not an exhaustive list of terms. I'm sure others will add to it, and/or correct any errors that I may have inadvertently made. I hope it may be helpful however.
