Orchiectomy

Orchiectomy Overview

We know this surgery is extremely important. It takes incredible trust to allow a surgeon to perform this operation. We want you to know we are humbled by that trust and take it very seriously.

The first step in this complex process is understanding your options and creating a plan that meets your needs. We’ve created this overview to help you make important decisions and know what to expect.
What is Orchiectomy surgery?
Orchiectomy is a surgery to remove your gonads. There are many reasons for this including not tolerating or not being able to take testosterone blockers, gender dysphoria from gonads, pain with tucking and others. It is recommended, if possible, to delay orchiectomy to the time vulvovaginoplasty as this can allow for more tissue for this procedure but this is not needed in all patients. You surgeon will discuss the plusses and minuses of choosing orchiectomy before vaginoplasty.

This procedure permanently removes the ability to have genetic children in the future. It is important to consider fertility preservation before this procedure in the case that you may choose to have genetic children.

This is an outpatient procedure, meaning that you will have surgery and will be able to leave the surgery center same day. In this procedure a small vertical incision is made on the scrotal tissue and the gonads are removed to the inguinal canal in the groin area. This is then closed with absorbable suture.

What to consider

Before your first consultation, we encourage you to:
· Consider your goals and priorities of surgery.
· Write down your questions and bring them with you to your visit.
· Ask a support person to come with you. Ideally, this is the same person who will care for you after surgery.

Your first consultation

Your first consultation is an opportunity for us to learn about your hopes and goals.. Your surgeon will review options and explain the process.

Once we understand your goals, we will:

• Evaluate your anatomy.
• Pre operative pictures may be taken
• Assess your overall health

After Care

This page contains answers to frequently asked questions regarding your care after an orchiectomy. This information will help you remember the instructions given to you after surgery.

What will I see when I look into a mirror?

There will be a vertical incision on the skin. These are all dissolvable sutures and will work their way free in the coming weeks. Itchiness, numbness slight burning or tingling sensation are all normal in the coming weeks of healing.

When can I shower or take a bath?

We ask that no showers for the first 24 hours. After can shower like normal. We recommend waiting 4-6 weeks before doing any soaking, swimming, or hot tubs.

What can I do after surgery?

We encourage you to walk as early as the day of surgery. Wiggle your toes to keep blood circulating to your legs when you are sitting or lying in bed.

Walking short distances is fine, and mild physical activity can be resumed as soon as you are able, but we encourage you to refrain from heavy exercise until we discuss this at your post op follow up visit.

When can I drive?

You generally should be able to drive in about 5-7 days after surgery if you feel up to it. You should not drive if you are still taking prescription pain medication.

How much pain will I have?

The most discomfort that you will have lasts 5-7 days, sometimes longer. As you feel more comfortable, your need for medication will lessen.

What medication should I use?

I will prescribe a narcotic pain medication for you to use as needed after surgery to control your post-operative pain. Follow the directions on the bottle for their use. Most patient will need only Tylenol and ibuprofen.

Can I drink alcohol?

Do not drink alcohol for 5-7 days after your surgery or while taking narcotic pain medication.

When will I be seen in the office after surgery?

You will normally be seen within 5-7 days after surgery. Because this is a more simple surgery if you are doing well you do not need to come to your follow up visit. Just let the office know.

How will I know if I am having a problem?

Urgent problems after orchiectomy do not occur frequently. These are complications that will require a change in your post-operative care:

Nausea that lasts more than four hours and does not respond to medication

Bleeding that is persistent and uncontrolled or enlarging scrotum

High fever lasting more than four hours and is not relieved with medication

Breathing problems after surgery can be a serious complication. If you develop any chest pain or shortness of breath; you must contact the office or be seen in the nearest emergency facility without delay.

Medication reactions may occur with any drugs prescribed for you. If you develop a skin rash, itching, vomiting, or diarrhea, stop taking your medication and call the office.

If you have any of the above problems or other questions, contact my office at (650) 570-2270.