In some instances orchiectomy (removal of the testicles) may be of benefit to a patient planning SRS in the future. The benefit may be psychological and may also simplify the management of hormones and therefore reduce the health risks associated with taking hormones for extended periods.
This procedure is done on an outpatient basis under general anesthesia. A midline incision is made into the scrotum and the testes and cords exposed. The cords are divided below the inguinal ring and both testes and spermatic cords are removed.
There are no sutures to be removed and recovery is usually quite uncomplicated. There may be some swelling and discoloration in the scrotum and some pain in the inguinal area due to swelling of the remaining cord in this area. These symptoms should subside rapidly.
There is some shrinkage of the scrotal skin following this procedure and that is a consideration for penile inversion technique vaginoplasty. Some of the tissues inside the scrotum can be left behind to limit this shrinkage somewhat.
A sterilization consent must be signed in addition to the customary surgical consents.
The effects on future Vaginoplasty/Labiaplasty
It is not a problem if the orchiectomy is carried out properly. Androderm
is a testosterone patch marketed by SmithKline Beecham
Pharmaceuticals. Each patch contains 12.2mg testosterone 2.5mg/24 hrs. The normal dosage is two patches each 24hrs. applied to stomach, upper back, upper arm, or thighs. The hormones contained in the patch promote retention of nitrogen, sodium, potassium, and phosphorus, and decreased urinary excretion of calcium. They also simulate the production of red cells by enhancing erythropoietin production. Androderm therapy the application of patches to a eunuch with no testosterone brings about resumption of normal sexual erection within about three hours. couples wanting to control sexual activity by a male that is a eunuch or gelding can manipulate hormone levels and sexual function and desire by application
and withholding of Androderm patches. Stopping therapy for one day will result in loss of erecile funcion wihin 24 hours.