Susan's Place Transgender Resources

 Hey all. I am trying to make a decision on whether I would want to do the procedure and if I do, how will affect my gcs in the future. My doctor as already said that because my t level is so low, like less than 10 , that she would be willing to do referral letters. Thanks

My surgeon, Dr Oates in Boston, says it makes no difference on future surgeries, aside from shaving yen minutes off the procedure. Other surgeons may have different outlooks.

Someone invariably chimes in on these discussions talking about "tissue not available for future surgeries", but there is no skin removed during an orchiectomy.

Quote from: SusanL on February 12, 2019, 03:41:39 PM
Hey all. I am trying to make a decision on whether I would want to do the procedure and if I do, how will affect my gcs in the future. My doctor as already said that because my t level is so low, like less than 10 , that she would be willing to do referral letters. Thanks

This topic is of great interest to me I am considering this pre SRS as well. I have contacted the Dr Sanguan Kunaporn  practice at PPSI. Their reply was no problem if the orchiectomy is carried out there.

Anecdotal heresay dictates that abdominal removal of the testicles and cord leaves no scarring in the scrotum and is preferable for SRS later on.

I would love to hear first hand experience with this.

Kind regards, Kirsten.

Thanks all. I might talk to my doctor about it again.  I will keep you all updated. Higs all!!!! :)

Quote from: Kirsteneklund7 on February 12, 2019, 05:59:08 PM

This topic is of great interest to me I am considering this pre SRS as well. I have contacted the Dr Sanguan Kunaporn  practice at PPSI. Their reply was no problem if the orchiectomy is carried out there.

Anecdotal heresay dictates that abdominal removal of the testicles and cord leaves no scarring in the scrotum and is preferable for SRS later on.

I would love to hear first hand experience with this.

Kind regards, Kirsten.

Times have changed, surgical techniques have changed, etc.  I do not see any reason why I should not have my bilateral orchi done the conventional way.

Yes anecdotal stories (fairy tales are also such stories) are saying this.  But nobody can come up with a reliable source for this!  And what problems are caused if the conventional method is used?
Mine come out in about 10 days, and they will exit my body in the conventional way!

Quote from: Dietlind on February 12, 2019, 08:25:31 PM
Times have changed, surgical techniques have changed, etc.  I do not see any reason why I should not have my bilateral orchi done the conventional way.

Yes anecdotal stories (fairy tales are also such stories) are saying this.  But nobody can come up with a reliable source for this!  And what problems are caused if the conventional method is used?
Mine come out in about 10 days, and they will exit my body in the conventional way!

Thank you so much for the reply Linde. I would love to hear your real life experience!
Also I hope your emotional experience of hormones is freeing for you.
I didnt cry for over 30 years but after crying I felt relieved and more free than ever. I cry whenever I need to and even when I dont!

Kirsten [emoji523]


Sent from my SM-G930F using Tapatalk

Quote from: Kirsteneklund7 on February 13, 2019, 04:37:28 AM
Thank you so much for the reply Linde. I would love to hear your real life experience!
Also I hope your emotional experience of hormones is freeing for you.
I didnt cry for over 30 years but after crying I felt relieved and more free than ever. I cry whenever I need to and even when I dont!

Kirsten [emoji3404]


Sent from my SM-G930F using Tapatalk

Yes Kirsten, it is wonderful and reliving to be able to cry, and to allow oneself to cry!
All my life, I had mostly female emotions, but I tried so hard to be a man, and very much overcompensated, and did not allow myself to ever cry!

I will report back, as soon as I can sit at my computer again (I still hope that my balls weigh 10 or more pounds, and I can have an instant weight loss  >:-))

Quote from: Dietlind on February 13, 2019, 08:18:50 AM
Yes Kirsten, it is wonderful and reliving to be able to cry, and to allow oneself to cry!
All my life, I had mostly female emotions, but I tried so hard to be a man, and very much overcompensated, and did not allow myself to ever cry!

I will report back, as soon as I can sit at my computer again (I still hope that my balls weigh 10 or more pounds, and I can have an instant weight loss  >:-))

Godspeed Linde.

Sent from my SM-G930F using Tapatalk

A surgeon I've spoken to suggested his life was a lot easier if he didn't have to deal with scar tissue on the scrotum.. Shrinkage can also be an issue if there is an extended delay between the orchi and SRS.

I had an orchi done almost a year ago. Best mid step I ever could have taken. My T is now undetectable ( <3ng/ml ). The lack of The and not taking Spiro and finasteride has been really nice. I do take a progesterone once per day.

It was a simple midline incision. I think it might make the recovery from future GCS less intense as the cords and blood vessels to the testes are already cut, sealed, and healed long before doing GCS. One less source of bleeder concern I would think. Plus the nerves are done being sensitive from being cut.

Quote from: SusanL on February 12, 2019, 03:41:39 PM
Hey all. I am trying to make a decision on whether I would want to do the procedure and if I do, how will affect my gcs in the future. My doctor as already said that because my t level is so low, like less than 10 , that she would be willing to do referral letters. Thanks

Your T levels might end up being better after having an orchiectomy, I had mine done recently and I think my levels have increased. I went off the anti androgens before Christmas and I had a blood test at 2 weeks and again at one month from discontinuing the blockers. My testosterone levels were increasing slowly, I thought it increased a lot more than it did and was surprised on how different I felt despite my levels not being that much different.
Then out of the blue there was an opening and I could get the orchiectomy I'd been waiting for, afterwards my hormones definitely fluctuated and then sort of levelled out. That was about a month ago so I'm due for another doctors appointment and blood test soon. It will be interesting to see where my hormones are at now, I have a strong suspicion that my testosterone has increased (hopefully into the female range as opposed to being undetectable before) my body hair has increased, my sex drive is slightly higher, I have more appetite and I don't feel as fatigued all the time.

Quote from: PurplePelican on February 13, 2019, 10:42:06 AM
A surgeon I've spoken to suggested his life was a lot easier if he didn't have to deal with scar tissue on the scrotum.. Shrinkage can also be an issue if there is an extended delay between the orchi and SRS.

Tissue can always be stretched back out, I don't know about the scar tissue though. I had my orchiectomy done ingiunal against the suggestion of my urologist, he didn't think the scar on the scrotum would be an issue and it apparently fades in time. What I do know about scars is that they can be tougher to cut into which is possibly a reason why some surgeons find it annoying. Regardless of which way an orchiectomy is done it doesn't void anyone from having SRS later as long as its done properly and not a home job.

Quote from: Dietlind on February 12, 2019, 08:25:31 PM
Times have changed, surgical techniques have changed, etc.  I do not see any reason why I should not have my bilateral orchi done the conventional way.

Yes anecdotal stories (fairy tales are also such stories) are saying this.  But nobody can come up with a reliable source for this!  And what problems are caused if the conventional method is used?
Mine come out in about 10 days, and they will exit my body in the conventional way!

Healing the conventional way is different, from what I've read the chords are not cut as short so they still can be felt in the scrotum and apparently there is a possibility that the chords can try to fuse with the inside of the scrotum.
Even with the ingiunal method where the chords were cut can still be felt its just further up in the groin, its been a month and I still have a tender spot if I feel for it.

I wouldn't be surprised if patient bias was a factor contributing to the online confusion about which method was better. I personally feel that healing and incision on a body part that I'm not comfortable even having would have caused me a lot of distress and I'd rather not have anything left still floating around in my sack. I'm glad I got to choose to go ingiunal, my dysphoria was a factor in my decision and I wanted to take a baby step towards what SRS could be like. I had never had any surgery done before and now I know having stitches in your crotch isn't fun, it hurts to heal and I would definitely think harder about getting SRS now I've had a taste of being sliced open.

Quote from: josie76 on February 13, 2019, 11:46:56 AM
I had an orchi done almost a year ago. Best mid step I ever could have taken. My T is now undetectable ( <3ng/ml ). The lack of The and not taking Spiro and finasteride has been really nice. I do take a progesterone once per day.

It was a simple midline incision. I think it might make the recovery from future GCS less intense as the cords and blood vessels to the testes are already cut, sealed, and healed long before doing GCS. One less source of bleeder concern I would think. Plus the nerves are done being sensitive from being cut.

I totally agree! best decision I've ever made it was well worth it. I don't know if anyone ever does regret it, I would say that it probably isn't a big deal to some but for me it definitely was

Quote from: Belladona on February 13, 2019, 04:34:40 PM
Tissue can always be stretched back out, I don't know about the scar tissue though. I had my orchiectomy done ingiunal against the suggestion of my urologist, he didn't think the scar on the scrotum would be an issue and it apparently fades in time. What I do know about scars is that they can be tougher to cut into which is possibly a reason why some surgeons find it annoying. Regardless of which way an orchiectomy is done it doesn't void anyone from having SRS later as long as its done properly and not a home job.

He commented that the scars on the scrotum are problematic in that they are inflexible and unusable, so that portion of the skin is often discarded. Stretching does prevent shrinkage, but only if you maintain it on a regular basis - it's not going to be much help if you ignore it until weeks before surgery, as some trans women I know would do, if they even did it all.

My urologist wasn't sure at first so he contacted different surgical units around the world and they all came back saying that scrotum scars didn't matter. With SRS an incision is made in the same place so they just cut along the scar. For any scar tissue to be discarded the scar would have to be quite wide and everybody scars different so maybe its not always an issue? It does sound like a small technicality but I've never heard of anyone being completely void from SRS because of it.
Still an orchiectomy has benefits, it might bother some surgeons but it would bother me for a hell of a lot longer if I didn't get it done.

Hi Folks,                         13 February 2019

Why don't we have an Orchie Party. Come to think of it, there wouldn't be enough nuts to go around. OK, on to the serious stuff.

I had my orchie last April 2018, Friday the 13th. It was a Bilateral, Radicle Inguinal, Orchiectomy. Took about 35 minutes, was done by a plastic Surgeon in Plano (Dallas) Texas. I had zero pain, minor discomfort for two days which was handled by 6 regular strength Tylenol tablets. I was back to doing heavy work 1.5 weeks after surgery.

My scrotum turned purple for about a week (blood that had drained into the scrotum called Hematoma), there was a small bit of purple on my future clitoris. These were all cleared up within one week. The scrotum has shrunk to a tiny pouch that's almost invisible. The two tiny scars, one on each side of the inguinal canals are almost invisible. I was looking for them the other day and had a very difficult time locating them. My guess is that they will completely disappear in the next year.

The spermatic cords were completely removed so nothing is dangling down into the scrotum. I have photos of my surgery which I would be willing to post if it were permitted. There's nothing sexy, sensual or raunchy about them, they are medical documentation. If the powers to be would permit them I'd be wiling to allow them to be posted. They could surely help dispel some of the misinformation and mystery of the Inguinal Orchiectomy.

If I were to do this again, I'd do it exactly the same except for one thing: I would insist on doing it without anesthesia.

In my opinion and in the opinion of others I have read, the simple, through the scrotum, is one of the most traumatic methods of doing an orchie. I think the term "simple" describes the method used by some doctors because it is simple for them. Look up Devlyn's thread on her orchiectomy. She has photos and commentary that could help you make a decision on which method to choose.

Hope this helps.

Best Always, Love
Christine

Here's my thread:  Orchiectomy cost and concerns  (https://www.susans.org/forums/index.php/topic,224375.0.html)

You know I had no blood pooling issues at all. My urologist cut the tubes and veins up into the inguinal canals but asside from stitching them closed he burned them closed. Honestly the midline was "simple" for me. The biggest problems I had we're the cat gut sutures that were used. My body really did not like those. In fact it caused my white blood count to be extremely high for nearly 2 mo the after before returning to normal levels. Those stitches caused me the most issue.

Quote from: Belladona on February 13, 2019, 05:04:35 PM
My urologist wasn't sure at first so he contacted different surgical units around the world and they all came back saying that scrotum scars didn't matter. With SRS an incision is made in the same place so they just cut along the scar. For any scar tissue to be discarded the scar would have to be quite wide and everybody scars different so maybe its not always an issue? It does sound like a small technicality but I've never heard of anyone being completely void from SRS because of it.
Still an orchiectomy has benefits, it might bother some surgeons but it would bother me for a hell of a lot longer if I didn't get it done.

Being a surgical person myself, I can ensure everybody that the modern cutting methods leave minimal scar tissue only, and if a follow up surgeon sees problems in this, the surgeon may want to study up on modern methods before cutting into my body!

Quote from: christinej78 on February 13, 2019, 06:58:06 PM


In my opinion and in the opinion of others I have read, the simple, through the scrotum, is one of the most traumatic methods of doing an orchie. I think the term "simple" describes the method used by some doctors because it is simple for them. Look up Devlyn's thread on her orchiectomy. She has photos and commentary that could help you make a decision on which method to choose.

Hope this helps.

Best Always, Love
Christine

Christine
The conventional method is the only one, my health insurance will pay for (those gate keepers again), and my urologist said he will try to take out as much cord as possible.  I hope they will allow me to be awake, but that is the hospitals call because their anesthesiologist will be responsible of that side.

For me the most important thing as to get those babies out of my body as fast as possible!  And it took about two weeks from convincing the urologist to get them out, getting the insurance to approve, and getting a time at the hospital!
Beggars can't be choosers!

Quote from: Devlyn on February 13, 2019, 07:05:29 PM
Here's my thread:  Orchiectomy cost and concerns  (https://www.susans.org/forums/index.php/topic,224375.0.html)

Devlyn,

Thanks for the thread.  It is a good source as I go down that path.

Julie

Quote from: Julie -2010 on February 13, 2019, 09:37:42 PM
Devlyn,

Thanks for the thread.  It is a good source as I go down that path.

Julie

You're welcome.  :)

Hugs, Devlyn

Quote from: josie76 on February 13, 2019, 08:25:23 PM
You know I had no blood pooling issues at all. My urologist cut the tubes and veins up into the inguinal canals but asside from stitching them closed he burned them closed. Honestly the midline was "simple" for me. The biggest problems I had we're the cat gut sutures that were used. My body really did not like those. In fact it caused my white blood count to be extremely high for nearly 2 mo the after before returning to normal levels. Those stitches caused me the most issue.

Cauterization is the modern way to close vessels.  A cauterizer is very often used to make incisions in body parts from which heavy bleeding is expected.  I have to talk to the surgeon if Steri Strips could be used for closing the wound?

I had steri strips! I would say that you probably can't have them if you get the simple method done, wouldn't the scrotum be too pliable for the steri strips to hold??

Also I didn't have any bleeding or pooling issues  :)

Quote from: Belladona on February 13, 2019, 11:36:32 PM
I had steri strips! I would say that you probably can't have them if you get the simple method done, wouldn't the scrotum be too pliable for the steri strips to hold??

That depends on the person who applies them.  If that would not go, skin adhesive should be great, too!  The problem is that many older surgeons do not like to relearn their techniques, and don't go to classes where they could learn new wound closure methods!
(I worked in the labs who created both of these wound closure means)

Hi Folks,                       14 February 2019

One item I think needs attention and has been overlooked by everyone, including me, is the skill of the surgeon you choose to do your orchiectomy. Before I made my decision on who was going to do mine, I did a lot of research into this subject. I have had so many surgeries I cannot keep track of them. None have been from illness, just "Damage Control" for injuries that occurred due to some of my stupid "Human Tricks," like skiing sloops I had no business looking at, let alone skiing. Hot Dogging it with a chainsaw; does a wonderful job of making normal body parts indistinguishable from ground meat.

All these "repairs" required surgery of some sort. Some are impossible to detect and others are quite noticeable. What I am getting at is the skill of the surgeon you choose; I chose the surgeon that did my orchie based upon my research into the three main types of orchiectomy performed; my findings indicated that Inguinal was the best method for the outcome I wanted. I asked around and got several referrals to the surgeon I eventually chose. He and the other surgeons in his practice, only perform the inguinal orchiectomy, and they do a lot of them.

I have a urologist I see on a regular basis who does a lot of various urological procedures. I would not want him doing my Orchiectomy because that's not something he does a lot of. Another thing I failed to mention was my surgeon used only dissolvable sutures with none being visible. After the incisions were sutured internally, a small strip of tape was placed over the incisions allowing them to heal without scabbing over, a major source of scaring.

At some point I will have bottom surgery, which will take place after I relocate to Phoenix. I've heard a lot of good things about Dr. Ley so I will schedule an appointment with her. If I feel comfortable with her doing my surgery she'll get to work her magic in making me more anatomically feminine. I know I will need FFS if I'm ever going to pass. Right now my face looks like the south end of a northbound mule heading for the glue factory.

Best to do your homework and choose a doctor that will meet your expectations. The orchiectomy is a one shot deal, no "Do-Overs" with this procedure; choose wisely.

Best Always, Love
Christine

Quote from: christinej78 on February 14, 2019, 03:11:28 AM
Hi Folks,                       14 February 2019

Best to do your homework and choose a doctor that will meet your expectations. The orchiectomy is a one shot deal, no "Do-Overs" with this procedure; choose wisely.

Best Always, Love
Christine

Christine, I did just that.  The urology partnership I am with has two docs wo do all the surgeries.  They are the biggest partnership in this neck of the country and associated with the Mayo Clinic.  This allows them to draw on all of my medical files.
The first urologist I saw referred me to on of the surgeons, and this is the one who will do my surgery.
That is as good as  can do, and  have to hope that I made the right decission.  He said that he will but the cords as high up as possible, and will cauterize the ends.  this way hey cannot connect with the surrounding tissue when healing.  I hope I made the right decission, but one never knows!

Quote from: Dietlind on February 14, 2019, 08:51:29 AM
Christine, I did just that.  The urology partnership I am with has two docs wo do all the surgeries.  They are the biggest partnership in this neck of the country and associated with the Mayo Clinic.  This allows them to draw on all of my medical files.
The first urologist I saw referred me to on of the surgeons, and this is the one who will do my surgery.
That is as good as  can do, and  have to hope that I made the right decission.  He said that he will but the cords as high up as possible, and will cauterize the ends.  this way hey cannot connect with the surrounding tissue when healing.  I hope I made the right decission, but one never knows!

Hi Linde,                         14 February 2019

Happy Valentine's Day everyone.

I'm not worried about the decisions you make; you have a unique perspective on this due to your intellect, education and years of experience in the medical field.

Take care Linde, I know everything will all turn out fine for you.

One of my regrets is that I didn't get to take my jewels home in a jar. Since I do have photos of them, once I relocate to Phoenix, I am going to search for a jeweler that will make a life-size replicate pair of silver charms, based upon those photos. They should make for interesting conversation.

Last but not least, I do Not miss those two dangly trouble makers; they caused more than their fair share of the problems I caused for others, which brings to mind an old saying: "Old too soon; smart too late." Glad they're history.

Best Always, Love
Christine

I have an HMO so I'm not really going to be able to pick my surgeon.  My Endo Dr says that Kaiser (HMO) does it all the time so hopefully they have skill in doing it.

Thanks all for the information.  It is really helpful.

Julie