Susan's Place Transgender Resources

So, everything went great, I'm at home recovering already. Apparently the procedure went faster than everyone expected, I was only on the table for 25 minutes.

My question is though, so far the is zero pain or bruising. Should I expect this to change within the next few days?

I've read about large testosterone fluctuations caused by the adrenal and pituitary glands, is this something I should be concerned about?

So far, that's all I have.

Thank you all in advance.

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Congratulations! Here's your Nutless card.  ;D

I had pretty significant bruising, but pain stayed manageable. I never read anything about fluctuating T levels, I was tested 19 days post surgery and had normal female T levels.

Speedy healing!

Hugs, Devlyn

Quote from: Devlyn on November 19, 2018, 12:17:49 PM
Congratulations! Here's your Nutless card.  ;D

I had pretty significant bruising, but pain stayed manageable. I never read anything about fluctuating T levels, I was tested 19 days post surgery and had normal female T levels.

Speedy healing!

Hugs, Devlyn

Lol. I'll gladly take that. How long after the procedure did the bruising start?

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Same day. Here's my thread, the pictures start on page five. https://www.susans.org/forums/index.php/topic,224375.0.html

Thank you so much.

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Congratulations!

There can't be many other places were you are genuinely pleased to hear someone has lost a body part.

:D

Nope. Though, it's already been beneficial. A friend of mine had back surgery today as well and I cracked a joke about it with hun already I even got him to laugh.

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Did anyone experience much bleeding post surgery?

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I had mine done in 1994. There was no bruising, and the only bleeding was from where I was stitched. It stopped that day. As a matter of fact, I felt so good that I walked the beach the following day.

Quote from: salaniaseviltwin on November 19, 2018, 04:56:34 PM
Did anyone experience much bleeding post surgery?

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I did, but that was because I apparently lost an internal stitch. The blood was obviously old based on the dark colour. Are you bleeding?

I have ab internal stitch as well. I've had a piercing down there previously, that bled a lot. So that's why I'm not freaking out.

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I'm assuming the bleeding has stopped, everything in there is dark and old.

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Not sure about the T levels, I quit spiro right away and didn't feel any significant changes that would be associated to a higher T level. A couple of months later I took a blood test and my T was pretty much dead.

And I was bruised and swollen for about a week.

Today has been amazing so far even though it started about an hour ago. This may be a bit TMI and if it is please let me know and I'll gladly edit it. The majority of the bruising on the scrotum is nearly gone and the only real pain that I'm dealing with is a crampy feeling on the right side of my abdomen. There was no bleeding yesterday, and today only a little bit of spotting over night. I think the general recovery may be a little faster than I had anticipated, but I'm still going to take advantage of my approved time off of work so that I don't mess anything up. Overall, not a horrible experience.

The one thing that I have a slight problem with is that I don't remember a couple of hours from each day. Not sure if that is my system still clearing out some of the anesthesia, or a side effect of the pain pills. I'm not too concerned about that because i've had it happen in the past due to various medications that I've taken.

I will say that it is definitely a new experience not having them down there.

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Thanks for the update! The effects of the anesthesia do stick around for awhile. I found myself remembering more and more of surgery day as time wore on (including the conversation in the operating room). I'm glad you're doing well.  :)

Hugs, Devlyn

Regarding testesterone fluctuations, according to one SRS surgeon about 10-15% of women experience high T after SRS and the treatment is antiandrogens for at least 3 months. It's also possible to have too low testesterone and need to supplement it, but I've not heard of this very often.

These are in regards to srs, but I'm pretty sure it would be the same for an orchi.

Day 5.

Bad news:
I've had a constant pain in my right side; rough description would be a kick in the balls, just a bit more dull. I've found myself unconsciously sitting with my legs closed, but spreading is more comfortable at the moment. I can't seem to sit for more than a few hours at a time at the moment, then I have to switch to lying down after standing and walking for a few minutes.

Good news:
From knowledge of my own body, I would say that visible bruising should be cleared up in no more than a week from today. Aside from the pain described above, I can move with relative ease, walking and standing are no problem.

If the pain persists in Monday morning, I will be contacting my surgeons office to see if it's any sort of issue I should be worried about.

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@ salaniaseviltwin
Please check your temperature to make sure you do not have an infection!

Quote from: salaniaseviltwin on November 24, 2018, 07:28:53 PM
Day 5.

Bad news:
I've had a constant pain in my right side; rough description would be a kick in the balls, just a bit more dull. I've found myself unconsciously sitting with my legs closed, but spreading is more comfortable at the moment. I can't seem to sit for more than a few hours at a time at the moment, then I have to switch to lying down after standing and walking for a few minutes.

Good news:
From knowledge of my own body, I would say that visible bruising should be cleared up in no more than a week from today. Aside from the pain described above, I can move with relative ease, walking and standing are no problem.

If the pain persists in Monday morning, I will be contacting my surgeons office to see if it's any sort of issue I should be worried about.

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Kicked in the nether regions is exactly what I felt afterwards, I hope you're fine, but absolutely check with your surgeon if you think there's a problem.

Hugs Devlyn

2 week update.

Pretty much all of the bruising is gone now with the exception of a few spots. The previous pain subsided shortly after the last update, but it's returned with a vengeance today. My follow up appointment is on Wednesday and I should be getting my work release note that day as well.

The one thing that I'm a bit confused about id that I can clearly feel what's left of my spermatic cords. Is that due to swelling, a mild complication, or my surgeon cutting too low?
If anyone has about insight before I see my surgeon, that would be awesome. I'll be selling him Wednesday regardless of any answer I get from you lovely people.

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Quote from: salaniaseviltwin on December 03, 2018, 09:59:47 PM
2 week update.

Pretty much all of the bruising is gone now with the exception of a few spots. The previous pain subsided shortly after the last update, but it's returned with a vengeance today. My follow up appointment is on Wednesday and I should be getting my work release note that day as well.

The one thing that I'm a bit confused about id that I can clearly feel what's left of my spermatic cords. Is that due to swelling, a mild complication, or my surgeon cutting too low?
If anyone has about insight before I see my surgeon, that would be awesome. I'll be selling him Wednesday regardless of any answer I get from you lovely people.

Those "knots" are normal. It will take a few months, but they will completely disappear. I thought I might be stuck with them as a consequence of surgery, but they're gone now.

Hugs, Devlyn

Thank you Devlyn. That's exactly what I was thinking. I glad that they are only temporary. They currently hurt a bit and had me a bit concerned, thankfully the pain is less than it was yesterday.

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I'm not sure if re-absorbed is the correct term, but that's essentially what happens to them. It will take awhile, so patience is required.

Hugs, Devlyn

Yes the knots absolutely disappeared. I was freaking out at first because they felt like 2 balls so for a moment I panicked thinking my doctor had messed up and put testicular implants in there to keep the same appearance. Then I had the next appointment and she laughed and said they would disappear.

Congrats!  Don't worry about the brusing.  It looks pretty dreadful but it goes away fast.  I wanted to comment on the issue of the cords.  When I had my orchiectomy I asked to have it done inguinal (not scrotal)  so as to remove as much of the spermatic cords as possible.  I had read that in some cases of scrotal orchiectomy the dangling cords can attach themselves to the scrotum and can become painful.  The only drawback are two faint scars in the pubic area.

On that note one interesting thing that was suggested by my doctor was to numb the cords before cutting.  The theory is that even tho you are "out" the pain impulses still go out to the brain and may set you up for phantom pains.  As the doctor said this happens fairly often with any amputation.  *Note this was suggested by my pain doctor.  And for what its worth I've never had any phantom pains which I think we all can appreciate.

My surgeon said he was fine doing it any way I liked.   I really liked the doctor and not just because he did my Orchi.  This is just me but I asked to be kept awake long enough to say hello to the people in the operating room.  I wanted to do that so they thought of me as a real live person and not a procedure.   They were quite nice about it and said to just tell them when I wanted them to put me under.  As I recall when they had my arms out and were securing me to the table and were getting ready to put in the catheter I voted to be knocked out for the rest.   

Quote from: JanePlain on December 06, 2018, 07:14:56 PM
Congrats!  Don't worry about the brusing.  It looks pretty dreadful but it goes away fast.  I wanted to comment on the issue of the cords.  When I had my orchiectomy I asked to have it done inguinal (not scrotal)  so as to remove as much of the spermatic cords as possible.  I had read that in some cases of scrotal orchiectomy the dangling cords can attach themselves to the scrotum and can become painful.  The only drawback are two faint scars in the pubic area.

On that note one interesting thing that was suggested by my doctor was to numb the cords before cutting.  The theory is that even tho you are "out" the pain impulses still go out to the brain and may set you up for phantom pains.  As the doctor said this happens fairly often with any amputation.  *Note this was suggested by my pain doctor.  And for what its worth I've never had any phantom pains which I think we all can appreciate.

My surgeon said he was fine doing it any way I liked.   I really liked the doctor and not just because he did my Orchi.  This is just me but I asked to be kept awake long enough to say hello to the people in the operating room.  I wanted to do that so they thought of me as a real live person and not a procedure.   They were quite nice about it and said to just tell them when I wanted them to put me under.  As I recall when they had my arms out and were securing me to the table and were getting ready to put in the catheter I voted to be knocked out for the rest.

It sounds like you had an amazing doctor. I didn't even think to ask for it to be done inguinal. My surgeon was a former associate of Dr. Loren Schecter, so I trust he knows more than I ever will on the subject.

I didn't know that fact until my follow up appointment.

I also got to meet everyone that was in the OR before they even wheeled me in.

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Basically 1 month update.

Everything seems to have healed. The only concerns now are the sutures that decided that they want to be on the exterior of my body during the healing phase. I have an appointment with a doctor in Wednesday that will say what to do in regards to them. All the scabbing had cleared and I'm now left with a neat little line that will be virtually invisible eventually.
The hard part seems to be that I still have zero energy, I've been getting what I'll call hot flashes, and cramps.
Obviously the estradiol will help with the "hot flashes."
Does anyone have any recommendations about regaining a bit of energy?

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I do but it might make some folks cringe.  My advice is to get your testosterone levels into normal (female) range.  After the Orchie your levels may land in the below normal range for women and you will have things like zero sex drive and or low to no energy.  I urge you to talk to your endo and ask about having labs done and talking about how to balance things so life is in the normal female range of hormones. 

I do it btw and having a sex drive is way better then the alternative. 

If thats not the problem talk to your doctor about your energy level.  Are you maybe just dealing with excessive daytime sleepiness?  They do have some meds for dealing with that.   *And do work! 

Glad you are feeling better and congratulations again.

Quote from: JanePlain on December 17, 2018, 05:50:52 PM
I do but it might make some folks cringe.  My advice is to get your testosterone levels into normal (female) range.  After the Orchie your levels may land in the below normal range for women and you will have things like zero sex drive and or low to no energy.  I urge you to talk to your endo and ask about having labs done and talking about how to balance things so life is in the normal female range of hormones. 

I do it btw and having a sex drive is way better then the alternative. 

If thats not the problem talk to your doctor about your energy level.  Are you maybe just dealing with excessive daytime sleepiness?  They do have some meds for dealing with that.   *And do work! 

Glad you are feeling better and congratulations again.

I second that. My adrenal gland is keeping me at high, but normal female T levels.

Hugs, Devlyn

Quote from: Devlyn on December 18, 2018, 03:02:47 AM
I second that. My adrenal gland is keeping me at high, but normal female T levels.

Hugs, Devlyn

That is great news.   My hormones seem to all need tweaks to get into the proper levels.

How long does Dr. Arnkoff recommend waiting to fly after an orchiectomy?

Quote from: orchicurious on December 23, 2018, 07:56:48 PM
How long does Dr. Arnkoff recommend waiting to fly after an orchiectomy?

I had an orchiectomy three weeks ago, though not with Arnkoff, and was okay to fly 48 hours after the surgery (per Dr. Ley), though I wouldn't recommend it. I walked a little too much that day because our terminal was moved at the last minute, so I had to get there without a wheelchair.

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Quote from: amydane on December 25, 2018, 07:16:47 AM
I had an orchiectomy three weeks ago, though not with Arnkoff, and was okay to fly 48 hours after the surgery (per Dr. Ley), though I wouldn't recommend it. I walked a little too much that day because our terminal was moved at the last minute, so I had to get there without a wheelchair.

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Congrats!

Quote from: amydane on December 25, 2018, 07:16:47 AM
I had an orchiectomy three weeks ago, though not with Arnkoff, and was okay to fly 48 hours after the surgery (per Dr. Ley), though I wouldn't recommend it. I walked a little too much that day because our terminal was moved at the last minute, so I had to get there without a wheelchair.

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Yes,  congrats. Hopefully I'll be there in a few months.

@ amydane, congrats!
I hope I will follow you soon.  I see an urologist next week to start the discussion!

Hi Folks,                       28 December 2018

There are three types of Orchiectomy: Radical Inguinal, Simple, and Subcapsular.

I had my Bilateral Radical, inguinal, Orchiectomy Friday 13 April 2018. The only incisions were about 1.5" on each inguinal canal. The scrotum was not cut. I had no swelling, no bruising and no real pain, just minor discomfort for two days that a total of 6 Tylenol took care of. The incisions were healed in a week, the scars are now almost invisible. Don't let the name of this procedure fool you, it is actually the simplest and least traumatic of the three orchie types.

The inguinal method makes it possible for the entire spermatic cord to be removed; nothing is left dangling down into the scrotum. My scrotum has shrunk to almost nothing. If you are contemplating bottom surgery at a later date, don't worry, the scrotal tissue is stretchy as always so you should have enough to satisfy the needs of GCS, which I plan on having next year.

I had my Orchie done by Dr. Peter Raphael in Plano, Texas (North Dallas). He and his team have their own surgery center. The total cost was $3500.00 for Pre op consultation, pre op checkup, Surgical suite, anesthesia, surgery, three post op checkups. He only does the inguinal procedure and he does it under GA. Though I tried, he won't let you take them home though I do have photos of the procedure. The orchie is one of the best things I have done for myself surgically.

One benefit of this procedure many folks don't know about, aside from riding one of "T," is that this procedure reduces ones risk of prostate cancer to almost Zero; something worth thinking about.

Best Always, Love
Christine

Hi christinej78,

Thanks for the information about your bilateral radical inguinal orchiectomy.

What letters of authorization did Dr. Peter Raphael require?

Also, does he offer the option of saline testicular implants?

Quote from: orchicurious on December 28, 2018, 10:16:18 PM
Hi christinej78,

Thanks for the information about your bilateral radical inguinal orchiectomy.

What letters of authorization did Dr. Peter Raphael require?

Also, does he offer the option of saline testicular implants?

Hi orchicurious,                         28 Dec 2018

I had two letters from Licensed Professional counselors, a letter from my Endocrinologist, and a letter from my Primary care Physician. I also wrote a bio that listed my time as when I started cross dressing and my evolution to living as a woman full time. Your best bet is to call their office at 972.543.2477 and ask to speak to Catherine Walker-Paul. She is Dr. Raphael's Senior Patient Consultant. She is very nice and helpful as is all their staff. Their facility is first class and you are treated very well. I especially like Dr. Raphael as he is easy to talk to and will explain any aspect of the surgery you want to know about. I was very satisfied with everything they did for me. Give them a call and you should be pleased with how they treat you.

You will have to ask Catherine about the implants. I didn't have any as I wanted the scrotum empty.

If you are a veteran or are in the military let them know. Hope this helps; I'm glad I had my Orchie done there and not elsewhere.

Best Always, Love
Christine

NO UPDATE, but the is a question for anyone that had the procedure done scrotal. The right "cord" has retracted, the left however seems to have attached itself to the incision during the healing. It also seems to be hard and rather large. Is this something that I should be concerned about given its been roughly 6.5 weeks?

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 I was informed by my urology surgeon that no surgeon in SW Florida will do an orchi just for transgender reasons!
But he also told me that an orchi would not bring anything for me, because my testes are so atrophied that it is very unlikely that they are able to produce any testosterone anyway.
They are that little for years already, and that could be the reason that the estrogen my body produces was enough to get my breasts growing!

Quote from: salaniaseviltwin on January 04, 2019, 08:07:09 PM
NO UPDATE, but the is a question for anyone that had the procedure done scrotal. The right "cord" has retracted, the left however seems to have attached itself to the incision during the healing. It also seems to be hard and rather large. Is this something that I should be concerned about given its been roughly 6.5 weeks?

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Contact your surgeon if you think the healing isn't progressing as expected. I did find that the knots dissipated at different rates. They were definitely still discernible for awhile.

Hugs, Devlyn

Quote from: Devlyn on January 05, 2019, 03:17:30 AM
Contact your surgeon if you think the healing isn't progressing as expected. I did find that the knots dissipated at different rates. They were definitely still discernible for awhile.

Hugs, Devlyn

Yes for sure this is a good thing to check in with your doctor about.

What has anyone done in regards to loss of energy? Any recommendations on improving or regaining that energy?

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Quote from: salaniaseviltwin on February 18, 2019, 03:52:28 PM
What has anyone done in regards to loss of energy? Any recommendations on improving or regaining that energy?

A loss of energy could be low T. A loss of strength could be normal female hormone levels catching up to you. Which are you experiencing?

The issue is definitely energy, which I will gladly attribute to low T. I successfully dropped from 250 to 20 after my orchi. But the low energy is kind of starting to annoy me.

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Quote from: salaniaseviltwin on January 04, 2019, 08:07:09 PM
NO UPDATE, but the is a question for anyone that had the procedure done scrotal. The right "cord" has retracted, the left however seems to have attached itself to the incision during the healing. It also seems to be hard and rather large. Is this something that I should be concerned about given its been roughly 6.5 weeks?

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Sorry I didn't reply to this question but the dangling cords problem and having them reattach was a concern that my pain doctor brought up.  His suggestion (Which I did) was to do this inguanaly and that way the cords could be cut high up so there would be nothing dangling around.  Its too late to do that but I expect there will be others who want to read about others experiences. 

Quote from: JanePlain on February 19, 2019, 07:09:43 PM
Sorry I didn't reply to this question but the dangling cords problem and having them reattach was a concern that my pain doctor brought up.  His suggestion (Which I did) was to do this inguanaly and that way the cords could be cut high up so there would be nothing dangling around.  Its too late to do that but I expect there will be others who want to read about others experiences.

This is sound advice and something I didn't think about to ask my doctor before the surgery. I will admit to not doing enough research.

It makes no difference cosmetically, but like you said, in terms of comfort it can make a bit of difference.

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Quote from: salaniaseviltwin on February 19, 2019, 07:49:33 PM
This is sound advice and something I didn't think about to ask my doctor before the surgery. I will admit to not doing enough research.

It makes no difference cosmetically, but like you said, in terms of comfort it can make a bit of difference.

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I mentioned this on another thread but the same pain doctor said to request the cords be numbed up before they are cut. His theory was that this might avoid have phantom limb / pain later. The idea is that any amputation has the nerves sending pain signals to the brain (even if you have a general and are totally out of it) Numbing the cords keeps these massive pain signals from "wiring" the brain.

As far as I know this was just a theory that my doctor had. For what its worth my orchie was quite a few years ago and I've had no problems with phantom limb or pains. Anyway as the surgeon said it couldn't hurt to do that so why not?

Hi Folks,                        19 February 2019

I've posted on this subject several times. Before I had my orchi, i did a good bit of research on the subject. There are three types of orchiectomy performed: Simple, Inguinal, and Subcapsular.

In my less than humble opinion, the inguinal (Bilateral, Radical, inguinal) orchiectomy causes the least trauma to the patient. Doctors performing this surgery (inguinal) require more training and experience. I had mine done by Dr. Peter Raphael in Plano (Dallas) Texas; He is a plastic surgeon and he and his staff do these on a routine basis. They are the only Orchiectomies they perform.

I had zero pain, mild discomfort for two days handled by 6 Tylenol capsules over the two days. I was back to doing heavy work 1.5 weeks after the surgery. There were no external sutures, all internal and dissolvable. The small incisions were covered by a small piece of tape which fell off after the incisions healed, less than a week. I have a difficult time locating the scars, which are very faint. I suspect by the time 2 years has passed they will be virtually invisible.

Which orchi is best? Only you can decide after doing your own due diligence. Would I do anything differently? Yes, I would have done it years ago and I would have done it without anesthesia.

Choose wisely, there is no going back for a "Do-over."

Best Always, Love
Christine

Quote from: christinej78 on February 20, 2019, 12:52:03 AM
Hi Folks,                        19 February 2019



Which orchi is best? Only you can decide after doing your own due diligence. Would I do anything differently? Yes, I would have done it years ago and I would have done it without anesthesia.

Choose wisely, there is no going back for a "Do-over."

Best Always, Love
Christine

For me it is the bilateral conventional, because the only cost I have is $250 copay!  That is the best argument for me for the one I am getting!

Quote from: Dietlind on February 20, 2019, 05:43:14 PM
For me it is the bilateral conventional, because the only cost I have is $250 copay!  That is the best argument for me for the one I am getting!

@Dietlind
Dear Linde:
Please un-confuse me,
I had thought for a moment that you already have had your orchi
but I am now thinking that your procedure will be on Friday February 22nd...
...am I correct with that revised thought? ???
Either way, I am always wishing you the best...

Hugs,
Danielle

Quote from: Alaskan Danielle on February 20, 2019, 09:11:50 PM
@Dietlind
Dear Linde:
Please un-confuse me,
I had thought for a moment that you already have had your orchi
but I am now thinking that your procedure will be on Friday February 22nd...
...am I correct with that revised thought? ???
Either way, I am always wishing you the best...

Hugs,
Danielle

I wish I would have it behind me Danielle!

I will see my endo tomorrow, and discuss with hm my new meds requirements, because no baals, no spiro!  That tuff started to drive me crazy!

Thank you again for your good wishes!
Linde