Orchiectomy before SRS

[Fae]

Would any of you who had an Orchi prior to, or instead of full SRS be willing to share your experience?  I am trying to find a surgeon in my area, or I am considering seeing Dr. Kimmel in Philadelphia because he is the most active and has good reviews, according to http://www.tsroadmap.com but I have only read a handful of first-hand accounts from Kimmel's patients.

I can't find a whole lot of information about Orchi for TG/TS patients without running into info for men regarding the treatment of testicular cancer, and that info is informative but not all that helpful.  I need to know more about the after-effects of the procedure.

[seldom]

Don't do Kimmel.

Its my only recommendation.

If you need somebody who is inexpensive (and works out of a decent hospital), Dr. Cardenas performs them in Mexico.  He is no more of an adventure than Kimmel who does everything in office, and I have read very few horror stories from Cardenas, he is just an alternative most people do not consider because most people stay in the US or go to Thailand for trans services.  He used to work out of a separate hospital, but I guess got enough money to build his own which he staffed with more english speakers than the previous one (I heard stories about it was useful to have a spanish-english dictionary from people who saw him before).  So if you would like an alternative...well he's it.  (I would be iffy on SRS because he is an unknown quantity, but orchi's are simple procedures that any general surgeon can perform.  He is primarily known for FFS procedures, and is actually considered to be decent at them.)

http://www.cardenas-plasticsurgery.com/

Also most people who do SRS also do Orchi's.

I heard too many horror stories regarding Kimmel.  Frequent infections, etc.  I suggest checking out the Eunuch board for information on him.  Not good.

[Fae]

Don't do Kimmel.

Its my only recommendation.

If you need somebody who is inexpensive (and works out of a decent hospital), Dr. Cardenas performs them in Mexico.  He is no more of an adventure than Kimmel who does everything in office, and I have read very few horror stories from Cardenas, he is just an alternative most people do not consider because most people stay in the US or go to Thailand for trans services.  He used to work out of a separate hospital, but I guess got enough money to build his own which he staffed with more english speakers than the previous one (I heard stories about it was useful to have a spanish-english dictionary from people who saw him before).  So if you would like an alternative...well he's it.  (I would be iffy on SRS because he is an unknown quantity, but orchi's are simple procedures that any general surgeon can perform.  He is primarily known for FFS procedures, and is actually considered to be decent at them.)

http://www.cardenas-plasticsurgery.com/

Also most people who do SRS also do Orchi's.

I heard too many horror stories regarding Kimmel.  Frequent infections, etc.  I suggest checking out the Eunuch board for information on him.  Not good.

Thanks Amy, I would prefer to stay in the US as I don't have money to acquire a passport, plus I've never left the states and I wouldn't feel too safe in Mexico.  I am hoping my endo can find a surgeon willing to perform the procedure for me locally.  I wanted to ask because I've only heard a few good stories about Kimmel, so thanks for the heads up.

[katia]

the only benefit of an orchi would be a lower hrt regimen provided that you don't  have grs in the future.  no thanks.

[seldom]

the only benefit of an orchi would be a lower hrt regimen provided that you don't  have grs in the future.  no thanks.

Thats the major benefit, but most endo's want you off Spiro after 4 years. 

Oh...Passports are CHEAP.  Cheaper than you think.  I will probably head to Mexico for scalp advance if my hair thickens more (I just started and it is thickening) and the hairline does not improve.  I am more comfortable going to Mexico than going to Thailand for this purpose, and the US doctors are just far to expensive and have a bad habit of recommending additional procedures when I just want one.    Plus scalp advance is something Cardenas is known for and I like the work I have seen from him.   

I have no choice with regards to SRS I have to stay in the US or go to Brassard because I was born in Illinois.     I would go to Thailand for that if I could. 

[Fae]

the only benefit of an orchi would be a lower hrt regimen provided that you don't  have grs in the future.  no thanks.

Thats the major benefit, but most endo's want you off Spiro after 4 years.

That's what I'm looking for; currently I'm not looking at full GRS because of costs and other reasons.  For me, it all boils down to what I can live with.  I just want the "T" out of my system, and the sooner the better.  I'm looking at getting an Orchi in one year because I am concerned about the bad side-effects of long-term HRT.

~Fae

[Sandy]

Would any of you who had an Orchi prior to, or instead of full SRS be willing to share your experience?  I am trying to find a surgeon in my area, or I am considering seeing Dr. Kimmel in Philadelphia because he is the most active and has good reviews, according to http://www.tsroadmap.com but I have only read a handful of first-hand accounts from Kimmel's patients.

I can't find a whole lot of information about Orchi for TG/TS patients without running into info for men regarding the treatment of testicular cancer, and that info is informative but not all that helpful.  I need to know more about the after-effects of the procedure.

Fae:

Check out my blog. 
https://www.susans.org/forums/index.php/topic,13143.0.html

I just recently had an orchiectomy and have been quite satisfied.  Besides reducing the amount of spironolactone in my system, I wanted the psychological comfort of having made positive and irreversible changes for my transition.  I did use a local doctor and was extremely pleased with the outcome.

It's been just about two months since my procedure and there have been no complications.  I had been on spiro for a while so the effects of testosterone were pretty much eliminated from my body already.  So I've already had all the standard effects.

If you have any questions, please feel free to contact me.

-Sandy

[Steph]

You may want to look at this topic Fae where the same issues were discussed at length:

https://www.susans.org/forums/index.php/topic,719.0.html

Steph

[Fae]

Thank you Steph and Kassandra, I appreciate your help.   

I'm glad everything went well for you Kassandra, I personally don't want to be on Spiro for too long if I can help it.

[rhonda13000]

I did and GRS is being anticipated.

I will defer on being procedurally explicit; it would exceed forum decorum.

It has not been fun. 

[Sandy]

Thank you Steph and Kassandra, I appreciate your help.   

I'm glad everything went well for you Kassandra, I personally don't want to be on Spiro for too long if I can help it.

As I mentioned in my blog, I won't be able to eliminate spiro from my regimen.  As my surgeon explained to me, about 90% of your testosterone comes from your testes, but you get approximately 10% from your adrenal gland.  Also about 10% estrogen comes from there as well.

Accordingly I still take spiro but at a much reduced amount.  Depending on future blood tests that amount may be reduced more.

-Sandy

[Laura Eva B]

As I mentioned in my blog, I won't be able to eliminate spiro from my regimen.  As my surgeon explained to me, about 90% of your testosterone comes from your testes, but you get approximately 10% from your adrenal gland.  Also about 10% estrogen comes from there as well.

Accordingly I still take spiro but at a much reduced amount.  Depending on future blood tests that amount may be reduced more.

I thought that the amount of T that the adrenal gland produces equivalates to roughly the amount of T that women have.  Without any T at all you are likely to be lethargic, have no sex drive, etc ....

Certainly since coming of Androcur post GRS my libido has returned big time  !  And I don't imagine the "10% of male level" of T is going to reverse the feminising effects of the estrogen I'm still taking.

Laura x

[Fae]

As I mentioned in my blog, I won't be able to eliminate spiro from my regimen.  As my surgeon explained to me, about 90% of your testosterone comes from your testes, but you get approximately 10% from your adrenal gland.  Also about 10% estrogen comes from there as well.

Accordingly I still take spiro but at a much reduced amount.  Depending on future blood tests that amount may be reduced more.

I thought that the amount of T that the adrenal gland produces equivalates to roughly the amount of T that women have.  Without any T at all you are likely to be lethargic, have no sex drive, etc ....

Certainly since coming of Androcur post GRS my libido has returned big time  !  And I don't imagine the "10% of male level" of T is going to reverse the feminising effects of the estrogen I'm still taking.

Laura x

I'm not too worried about the adrenal glands after an Orchi, whatever level of T they produce should be irrelevant.  Estrogen is feminizing my body well enough now on the Spiro and I think after my Orchi I can drop to a lower dosage of estrogen and eliminate the anti-androgens completely, but this is something I'll have to talk to my endo about.

My endo is currently looking for a local surgeon who would be willing to perform an Orchi for me, but I think it would be a good idea (for all parties, myself and my endo/surgeon) if I followed the Standards of Care and did one year RLE before an Orchi.

Oh, and Kassandra I did manage to read your blog about your orchi experience.  Thank you very much, that was quite helpful. 

~Fae

[inncdava]

I am deciding on where to get my orchedectomy done as part of my transition. I have chosen Dr. Reed of Miami since he only charges 2 grand for that and maybe a discount if you are a donor.

Unfortunately for me, that may be the only surgery I may be able to afford at this time.

[Sheila]

I had an orchi done prior to GRS. What I have read that it isn't recommended if you plan on haveing GRS. I had one, thinking that would be all I needed. I really didn't have the money at the time nor did I want to spend that much money. I got my GRS about two and half years after my orchi. I found that I just needed to be female all the way. The orchi was not enough for me. I had a urologist do mine. It wasn't so bad. I went back to work after a week, I did some light duty work, I was the boss so I could schedule myself into light duty. I started to develop a lot more after the orchi. I guess the spiro wasn't doing a very good job.

By the way, Thailand is great for surgeries. I went there and I know a lot of other girls that have gone. I had no problems when I got home here and I had no complications at all. I know some girls got everything done there. So don't be afraid of Thailand.
Sheila

[LynnER]

I've done allot of checking into this area myself...
You can probably find a local doctor to perform the surgery at about the same rate you find everywhere else... with out paying the travel/accomidation fees... They generaly operate on men with testicular cancer which means they have experiance in the area. There is more than one type of orchi too...  one where they cut directly into the scrotum and one where they make twin insicions in your lower abdomen and pop them up through leaving the scrotal tissue untouched and unscarred...  probably better for GRS but could lead to other complications.

Also if your planing on an orchi first...  Look at your time table... if your getting GRS in a year or so, its probably safer so far as tissue shrinkage goes for the orchi, but the cost differental makes it a pointless endevor sence no GRS surgeon gives a discount for allready having an orchi and some actualy charge more due to the complications that could cause.

Figure out who you want as your final surgeon and check there websites and other info on them first.  Some are not bothered by an orchi, others are.

Finaly look at the amount of raw meterial you have... if you have an over abundence an orchi is probably safe, if your negligable it might be wise to suffer them being there alittle longer as to avoid costly and painful skin grafts or the need for a colon section durring GRS...  Do your own research...  hope this helps

[Fae]

I've done allot of checking into this area myself...
You can probably find a local doctor to perform the surgery at about the same rate you find everywhere else... with out paying the travel/accomidation fees... They generaly operate on men with testicular cancer which means they have experiance in the area. There is more than one type of orchi too...  one where they cut directly into the scrotum and one where they make twin insicions in your lower abdomen and pop them up through leaving the scrotal tissue untouched and unscarred...  probably better for GRS but could lead to other complications.

What if an Orchi is your final step as part of a TG transition, and you're not planning a complete TS transition like I am?  Are doctor's able to remove the scrotal tissue, and what complications could arise from this post-op?

~Fae

[LynnER]

I dont know, youd have to do the research yourself.......

[Fae]

I dont know, youd have to do the research yourself.......

I've done allot of checking into this area myself...

Ok, allow me to rephrase the question.  Would you be able to share your research, as I'm not able to find much info about the issue?

~Fae

[LynnER]

Sorry.....
I havent done any research into haveing an orchi as a final procedure.  I havnt checked with any doctors to see if they remove the scrotal skin, though I do understand its a pretty simple procedure. Orchi's are the grey area in the SOC, it seems its purely up to the doctor weather they will perform the procedure.  Id sugest calling around to local surgical urologists <they seem to be the ones who most frequently perform this sort of operation>  It might give you a better idea of whats available and what they require inorder to op you.  Chances are they will ask for some sort of note from your theripist.