Orchiectomy

• Orchiectomy is the surgical removal of the testes from the scrotum. The standard procedure is a simple bilateral orchiectomy, which preserves the scrotal sack.
• The scrotum will shrink down somewhat. If you plan to have vaginoplasty in the future, please discuss different surgical technique options with your surgeon.
• The procedure takes between 30-60 minutes under anesthesia. You will be in recovery for a couple hours and then sent home for this outpatient procedure. After Orchiectomy you will want to talk to your primary care provider (PCP) about reducing spironolactone and hormones.
• Please talk with your PCP and navigator to help you make an informed decision to see if orchiectomy is the best option for you.

Patients who understand the surgical and non-surgical procedures for facial surgery often have a more successful consultation experience. Your navigator will provide surgical education and help you prepare for consult. Talking through your expectations, desired outcome, and concerns can be helpful practice prior to seeing a surgeon.

What Questions Should I Ask My Surgeon?

Expectations

• Will I be able to have an orgasm and what sexual functioning changes may occur?
• What are the possible complications of this surgery? 
• What can I expect healing to look like?

Planning

• What choices do I have in surgery procedures and what is best for me?
• I want to get vaginoplasty in the future, are there specific considerations I should think about?
• Where will my surgery take place and how long will it take?
• How long will I need to take off work/school?
• What medications or hormones do I need to alter or stop before surgery?
• What medical supplies will I need for recovery?

Your PCP, surgeon, and Gender Health Navigator can help you achieve optimal surgical outcomes by actively preparing for your surgery and making sure expectations are surgically possible.

PHYSICAL HEALTH

• Maintain a healthy body weight, high body weight can increase complications and interfere with wound healing.
• Although there is not a strict Body Mass Index (BMI) requirement, your surgeon may discuss specific anesthesia risks or considerations, depending on your BMI. It is beneficial to reach your own personal sustainable goal weight prior to surgery

MENTAL HEALTH/WELLNESS

• Having surgery takes both physical and mental preparation.  Surgery is stressful, some people feel an increase in depression or anxiety after surgery. 
• If you notice any changes in your mood or sleep, especially with anesthesia, please discuss with your care team.
• If you struggle with mental health, reach out to your mental health provider or navigator for support.

SMOKING

• Nicotine intake by smoking, patches, chewing gum, or vaping may interfere with wound healing. If you use nicotine, you should discuss a quit date with your PCP and surgeon. Surgeons require patients to stop nicotine prior to surgery and may test for confirmation.
• If you inhale cannabis, it’s important to find another way to use it, for example, topical, edibles, and tinctures, or to stop altogether.

SUPPORT

Build your network of support with providers, family, and community to help you plan and organize your recovery prior to and after surgery

• Transportation to and from appointments 
• Meal planning and preparation
• Providing a calm and supportive healing space

Everyone heals differently. Patients will experience:

• different levels of pain
• bruising
• swelling.

Each aftercare recovery plan is catered to a patient’s unique medical needs. You will receive post-op care instructions from your surgeon, make sure to review these instructions with your surgeon, PCP, and navigator as needed.

For optimal results and to help avoid complications, it is essential to follow post-op directions and engage in follow up care appointments as scheduled.

IMPORTANT CONSIDERATIONS

• Sterilizing procedure, meaning having biological children will not be possible after completion. A family planning and fertility discussion with your care team is an important step in your surgery process.
• Undergoing orchiectomy permanently removes your body’s ability to produce the hormone testosterone. It is important for your health to take hormones for life—to help prevent osteoporosis (weakening of the bones) and to help regulate your mood. Plan with your PCP to stop spironolactone after surgery and adjust your hormone therapy as needed.
• If you want orchiectomy before vaginoplasty, surgeons recommend waiting one-year post-op. This allows your nerves to heal and inflammation to resolve.
• Changes to sex drive and sexual function will occur.
• Considered a major surgery that carries standard risks and complications.

• Medicare A&B
• Full Scope Medi-cal
• San Francisco Health Plan (Medi-cal, Healthy Workers and Healthy Families)
• Anthem (Medi-cal)
• Healthy San Francisco (Health Access Program)