Orchiectomy Questions

[herekitten]

Rose City Rose -  When you decide on your doctor and have the procedure, would you please post? I am following your search, experience and results.  Thanks much! and feel free to reach out to me. I'll continue watching for your post.

[Tessa James]

My 33 year career was as a CRNA, nurse anesthetist.  An orchiectomy can be accomplished relatively quickly (a half hour) and varying degrees of intravenous sedation and anxiolytic medication can be administered with the primary anesthetic being a local.  Let's assume that your team interviews you ahead of time and will do their best to meet your needs as an individual.  I had many patients so relaxed and comfortable they snoozed through it or we told jokes and traded stories.  A general anesthetic is safe but more expensive and depending on your health going in a bit riskier.  I plan an orchiectomy too and had a vasectomy many years ago that feels about the same.  All for a worthy cause eh?

[SorchaC]

There are some funny and colorful visuals in this thread! 

When I look in the mirror each morning I see some funny visuals as well  Not sure what down there looks like anymore, One of the advantages of being overweight is the belly hides that part of the body 

Hugs

Sorcha 

[franie]

 I had my orchi a year ago. It was preformed under a local I had every little pain afterwards. Since I was not planning on having  a SRS she removed the scrotum as well all lose skin because I had lost a lot of weight. My only regret is that I didn't have it done years ago.

[Rose City Rose]

Another question has come up for me now.

I'm actually hyper-aware of my testicles (always have been) and hyper-aware of any sensation of them being there, especially pain (and I have an aversion to testicular pain in particular).  I have pain and discomfort there a lot, some of it caused by a varicose vein but a lot of it's just somatic.

I'm just worried that once they're removed, the somatic symptoms might continue and I'll feel phantom testicles down there and they'll continue to bother me.  I really don't want that!  How likely is that to happen?

[SorchaC]

Maybe I'm not the right person to answer this as I very rarely felt mine but on occasion I did. I have not had any phantom pains from the area at all. It's like they never existed.

I'd suggest maybe contacting a Doctor or even a Surgeon and ask them what are the instances of this happening. If you already have a Psychosomatic pain isue then it could be that you should seek help for this before continuing with the surgical route. Allot would depend on your reasons for wanting an Orchie

Hope that helps

Sorcha 

[bibilinda]

Another question has come up for me now.

I'm actually hyper-aware of my testicles (always have been) and hyper-aware of any sensation of them being there, especially pain (and I have an aversion to testicular pain in particular).  I have pain and discomfort there a lot, some of it caused by a varicose vein but a lot of it's just somatic.

I'm just worried that once they're removed, the somatic symptoms might continue and I'll feel phantom testicles down there and they'll continue to bother me.  I really don't want that!  How likely is that to happen?

Hello, Rose!

This is a very lengthy response. Sorry I couldn't make it any shorter, I did try though. Please read it carefully when you have some free time, it may be useful to you!

I had both orchi and t-shave almost exactly four years ago. My Dr. for that procedure is a plastic surgeon specialized in SRS, penile inversion technique. So those two procedures I had done, were really no big deal for him.

When I have an important procedure, like those two, I write a journal --until I fully recover and there's no issue, no need to keep writing in it-- and i take pictures of the area, before, after, etc. I also document the meds pre and post-op and the doctor's  instructions.

Anyways,  on the specific issue of the "phantom testicles" you mentioned.
Here's an entry in my journal, post-op: (This is only regarding the orchi, I also added stuff related to my trachea shave but of course that is not relevant to your issue, so I've left it out).  NOTE: These are my personal and REAL experiences post-orchi, yours may be similar or entirely different, for the better or the worse, but at least you are having now some real-life insight about your specific question.

QUOTE

(Days 1 to 3 post-op):
SCROTUM: Bleeding (dripping) continues. No apparent bruising. there's a weird feeling like pain, like the testes are still there and the pelvis area is swollen, as well as the scrotum, as if the balls were still there."

(Day 4th post-op:)
This day, an acute pain appeared in the pelvis area, mostly on the right side. Pelvis (specially right side) and inside of scrotum (specially left side, like a testicle is still there) are swollen.

(Days 5th to 10th post op)
The acute pain in the pelvis area continues, now on both sides.
Days 9-10, the pelvis swelling decreased, but the left side of the scrotum formed a little lump which hurts (a piercing pain), which looks and feels like a blood clot.

(Days 11th and 12th post op)
Bruising and discoloration have decreased substantially by now.  The acute pain in the pelvis area decreased substantially. The left side of the scrotum formed a little lump which hurts (a piercing pain), The little lump inside the left side of the scrotum (possible blood clot) decreased substantially today (more than 50%), maybe as a result of taking aspirin, and vitamin E at the same time, the night before and in the mid afternoon of  the 11th day. On the 12th day there's still a bit of pain on the left side of the scrotum.

UNQUOTE

So that was it, after the 12th day post-op I stopped my surgery journal, which means the discomfort was mild from that point on.

I also kept all the email communications post-op with the doctor. Here's some interesting stuff about the issue you brought up: NOTE: I am just quoting the talk related to the issue at hand.

QUOTE (selected from actual emails from me to my orchi Dr., the 7th day after the procedure)

Q (Bibi)  Hi, Dr. Please pardon my big ignorance, if that's the case for this message. I definitely have a big lump inside my scrotum, that looks and feels EXACTLY like I still have at least one testicle in there (the left one). I expected to be left with  just a flat and completely empty/deflated piece of skin just hanging over there, not a scrotum filled with something that looks and feels like I still have testicles in there. It makes me think maybe there was a mistake or something and both my testicles were not completely removed, otherwise there's a big accumulation of some tissue which I ignore what it is, but looks and feels like a testicle.
As I said, maybe I am a complete ignorant but then again, there could be a slight chance that a mistake was made and for some reason I am not 100% without testicles as of now. I am so traumatized right now with the thought any of my testicles being left there, that if another surgery is needed, I'll ask you this time to better get rid of the skin (scrotum) as well , so I can be 100% sure you got rid of the very hated glands.

A (Dr) Dear Bibi,
Of course both testes were removed, you can check the incisions one on each side. It would have been useless to remove only one! There must be swollen tissue that´s giving you the impression of having a trsdtyicle there, and it will resolve with time and ultrasound. Speaking of ultrasound, you can have an ultrasound made this week just to make sure that there are no testicles in the scrotum, and that the mass that you feel is just inflammatory tissue or a blood clot. Either way treatment is conservative. Please stop worrying, I assure you your testicles are gone forever. I didn´t save them for you to look at as I was pretty sure you wouldn´t want to see them. Yet the hospital records are there and you could talk to the assistant. Her name is  (  )  and her number is  (  ).   Also try calling Dr (  )  the anesthesiologist who also is a trained sexologist. She´s very interested in your case and can certainly help you. Her numbers are (   ) (  )

Q (Bibi) I can't afford ultrasound in any shape, way or form as of now, so I'd like to know if there's any other way to avoid fibrosis, via regular or alternative inexpensive medicine, exercises, diet or whatever. The 4th day after the procedure --today is the 5th, I hope it gets better!--, the whole groin area  looked purple/blackish, did hurt very uncomfortably and some areas even looked blistered and red, sort of like the area was burned with fire and the skin was about to burst.  If the color keeps purple/black tomorrow, the 6th day, I'll inform you, because something may be wrong given the case.

About the meds, the antibiotic is gone, metamizole you indicated to take it only twice and I did, so currently this is what I am taking, every 8-12 hours:
Vitamin C, 1000-1500 mg per intake
Aspirin, two 500 mg tabs
Deodorized Garlic 4-6 soft capsules
Ketorolac, I took it the 2 days after surgery every 8 hours; now I take it only when it hurts a lot (the groin area).
Calcium, one 1,500 mg tablet with main meal of the day.

A (Dr) Bibi, no wonder you have inflammation and pain...I prescribed the ketorolac every 8 hours continuously, not for only the first two days. Please continue to take it, now at 8, 14 and 22 hours for another two weeks. Also masturbation will make the swelling worse, increase the groin pain and certainly worsen the redness and bruising. Do call Nurse (  ) and Dr. (  )  who were present at your surgery. They can tell you the truth.

UNQUOTE

***********************************************************************************
OK, there you go, I shared all this very personal stuff with you, because I get the vibe that you're similar to me, before orchi, in that you TOTALLY HATE the damn little trouble makers and want to know nothing about them right after you wake up after the procedure, and never ever remember they were even there.

As you can see, even after the procedure, I was so apprehensive with the pain and still-there sensation (every bit the same as what people who lose limbs feel, for some time after their limb was removed), that I confused inflammation and small blood-clotting pains for the idea that at least one of the damn trouble makers was still there.

I still had the sensation of one of them still being there for probably a whole month, that annoying pain one gets when one still has those things, when you unintentionally hit them ad you have that endless pain in the pelvis area. After that, I still had the sensation from time to time, but much less than the first month, until some day it all just disappeared.

But I assure you, four years after my orchi  that now it feels like I NEVER HAD ANYTHING IN THERE AT ALL! Too bad I didn't have anyone to tell me their experience as I'm telling you (of course you may or may not have the same post-op issues as I did), but it MAY happen to you, something similar to my ordeal, so now you can be put at ease, or at least I expect you can feel that way, because now you know that you can expect such things to maybe happen, but they should go away pretty soon! Just follow the Dr's post-op instructions to the letter and I'm sure you will be fine, or at least will do much better than me at that time!

Good luck with your procedure!

Cheers

Bibi

[Rose City Rose]

Thanks Bibi, the long-term outlook seems encouraging, though I really cringed at the part about the blood clot and having that particular feeling for weeks on end.  Is that typical?

[Mindy More]

Hi everybody, I figure I should chirp in here.  Most things have been addressed, a few things haven't come up yet.  I had the procedure done in May under general anesthesia.  Had no issue with pain management, swelling, phantom testicles.  I do have something that resembles a blister, or pimple, which doesn't go away, and is painful to touch, which needs to be checked out, at the incision line.  I think it's a healing issue... if your Dr is using self-dissolving sutures, make sure they don't get absorbed back into the body, don't be afraid to check, as I didn't.  They don't dissolve like crystal light, more like break down enough to fall out (or fall in) as I think that is what I am dealing with, unless ingrown hair.

So the reason I had it done, was to nip testosterone in the bud, as HRT was only partially effective at 15 months, on maximum dosages.  Still plan on SRS, have not been vigilant about stretching anything, but reading what you girls have said has given me the kick I need.

Now for the real problem I want to share.  My hormone levels have been checked twice since the procedure, and definitely my T is down to around 17(parts per something), with 0-100 being the normal female range.  I don't think I'm breaking the rules by sharing that, since it's not HRT related, but feel free to let me know. 

Okay, so my energy levels are SO LOW, for the last 5 months, I really struggle.  Really, really, struggle.  To the point where my endo has given me testosterone gel and kicked up my E.  I can only hope this is an adjustment period, it really freaked me out in the beginning, to the point of having regular anxiety.  Once the dust settled and I healed, fatigue became my middle name.  I'm dealing with it though, managing, and have realized that it's just part of my transition experience. 

Second, weight gain.  Have put on 15 lbs, from 162-178 lb @ 5'11".  Okay, so I have realized that I am going to have to incorporate exercise into my life, forever.

Third, sex drive.  On HRT is was probably about 20% what it was originally.  Post-orchie, about 3%.  Do I still have fun? Yes.  Is it non-existent? No.  Am I losing something by not having the drive to release pent up energy through regular self-maintenance? Maybe. 

Do any of these things matter now? NO. It's done.    They may matter to you though, if you haven't pulled the trigger yet.  Do I regret the decision, Nah.  But do I drink 10 energy drinks a day, yeah I do.

[SorchaC]

Now for the real problem I want to share.  My hormone levels have been checked twice since the procedure, and definitely my T is down to around 17(parts per something), with 0-100 being the normal female range.  I don't think I'm breaking the rules by sharing that, since it's not HRT related, but feel free to let me know. 

I've found over the last few years since the Orchie that my levels of T and E have seriously been messed up. There was a period pre orchie also when at least the E was wrong and my doctors haven't been able to link any of this to having an Orchie.They so far at least don't have an answer so it was interesting to hear someone else is having the same thing.

Okay, so my energy levels are SO LOW, for the last 5 months, I really struggle.  Really, really, struggle.  To the point where my endo has given me testosterone gel and kicked up my E.  I can only hope this is an adjustment period, it really freaked me out in the beginning, to the point of having regular anxiety.  Once the dust settled and I healed, fatigue became my middle name.  I'm dealing with it though, managing, and have realized that it's just part of my transition experience. 

I found it the other way. I was so full of energy and vigour that I was doing 2 hours a day on an exercise bike, Yes that's what caused the stitches to give a but and the infection that followed. Maybe it was the extra motivation of knowing I could have SRS if I lost the required weight. We are all different and so you are right to share this because some others likely will experience loss of energy and they should be a ware it could happen.

Hugs

Sorcha 

[paxi1334]

the main issue with the orchie is in _how_ it is done.  when i had mine, i wasn't considering SRS and so the urologist did it the normal way he usually does it for testicular cancer patients - this caused scarring in an area which made it hard for my SRS surgeon to work with and, in fact, led to there being only minimal depths.  if SRS is even a possible option, make sure the urologist knows this & make sure s/he realizes that with future SRS patients, the incisions are made on a different part of the body.  summation: it needs to be a mtf orchie, not a general run in the mill orchie.

[Tessa James]

Good point Paxi,

We have plenty to consider as we take these profound steps.  I am working toward an orchiectomy and also not considering SRS.   Therefore it makes sense to consider having it performed by a surgean familiar and responsive to our needs.  Right now the idea of having no testes or scrotal sack and a cosmetic closure sounds best for me.  Surgeons can use a subcuticular type of closing stich as oppossed to the perpendicular stiches.   Ah the best laid plans of mice and women:-)