I had an appointment with my urologist this morning as a followup for the nerve block due to orchalgia.  This is the first time I've seen him since my therapist referred me for HRT and recommended an orchiectomy so I don't have to use spiro or another blocker.  So I had to fill him in on what was going on and I'm wondering if he has other trans patients because he seems quite knowledgeable.  He asked a few questions including what endo was I going to and what surgeons I was thinking about.  After we left, my wife said he seemed to be impressed that I knew what I was talking about and gave him answers immediately.  He did ask her how she was doing through all this and she told him fine.  As we were wrapping up, he said with the letter from my therapist he would do the orchiectomy.  Plus, since I've had an ongoing battle with severe pain on the left side. along with 10X higher risk of cancer on the right due to undescended testicle, he would use that diagnosis and not mention transgender so Medicare and my insurance will pay for it.  One thing for sure, he isn't gentle. LOL  I had to come home and take some heavy duty pain meds and lay down due to the residual pain from the exam.  

If reassignment surgery is on your list, it's important you doctor know that and the surgeon will do it as he will need to make the incisions in a different location than he normally would.

I still recall your story about you and your wife laughing when he talked about removal at the last visit. I hope you were able to have some fun with it this time like doc, I thought about it and I want to be a girl 

I used that as a lead in to the explanation.  I said, "Remember last visit when you said my wife wants a husband, not a sister?"  He said he remembered.  I told him, "The reason we both laughed so hard is I've been seeing a gender therapist and..."  That led into the explanation of what was going on.  Like I said, he seems very knowledgeable and asked pertinent questions. 

I've heard people say that about an orchiectomy and later GCS.  What I'm wondering though is if that would affect the partial vaginoplasty where no vaginal canal is created.  Since I would be a minimum of 68, close to 69 and Miss Dee isn't going to let me be going out on dates I'm 99% sure that's what I would opt for.  Anybody have any knowledge on that?

Again it depends on  what the surgery is going to need skin for. If I would have had that type of surgery, an incision down the center would have been best because the skin was divided and half went on either side. I have seen surgeries where it is used for a vagina and a side incision toward the back would be better. Start looking for the doctors who will do the next stage of the surgery and ask both doctors what their plans are because these surgeries are very custom depending on what you have to work with and the style of surgery the doctors uses.

Communication is key.  I'm going to have to go through a few complications myself due to malignant hyperthermia.  Just have everyone you're consulting know each other's plans, that way you don't come across any strange trouble Things can't go wrong as long as the information flows