Bilateral Orchidectomy, with or without excision of scrotal skin can be a definitive or intervening step for Trans Feminine patients on their journey.
Removal of scrotal skin should be considered carefully, since this tissue is used in the creation of the neovagina, and once removed is not available for use later on. Similarly, some patients get significant scrotal skin retraction following removal of the testicles. This can also reduce the amount of skin available for further neovaginal creation.
Some patients suffer significant side effects from their anti-androgen medications. Orchidectomy can help eradicate these side effects by removing the need for the anti-androgen therapy.
This procedure can be combined with other surgeries.
Orchidectomy is performed through an incision through the midline scrotal raphe. The testicles with the spermatic cord are dissected back to the external inguinal ring where they are divided and the cords ligated. The wound is sutured with dissolving sutures.
Frequently Asked Questions
During your consultation with Mr Ives, you will be asked about your past medical history and your general health. You will also be asked about your journey to date, including if and when you started your hormone therapy.
Mr Ives will then examine your abdomen and perineum. Skin quality and tissue volume will be assessed.
Mr Ives will then discuss the operation with you. He will also discuss the postoperative regime and the amount of time you will spend in hospital, as well as the length of time you will need to stay in Melbourne if you are from country Victoria or Interstate.
A second consultation will also be arranged. If you are one of our interstate patients this can be done over the phone.
At the second consultation Mr Ives will discuss the operation and the risks of surgery with you again.
You can book surgery for whenever. However, Mr Ives will not perform the surgery without the WPATH criteria being met and having the relevant report(s) See "WPATH criteria".
Mr. Ives performs most of his gender related surgeries at Masada Hospital in East St. Kilda.
Any operation has risks associated with it. Complications occur rarely. Mr Ives will discuss these with you during the consultation.
General complications include:
- Keloids (lumpy scars)
- Deep Vein Thrombosis (DVT) – clots in the legs
- Haematoma (collection of blood in the wound) and bleeding
- Anaesthetic complications
Specific complications include:
- Permanent reduction and retraction of scrotal skin which may affect potential further surgical options
Mr Ives performs this procedure under general anaeasthesia. Some patients can experience abdominal pain following surgery due to ligation of the spermatic cord.
This usually settles overnight. Most patients can resume daily activities after about a week.
If you are from interstate, you should be plan on being in Melbourne for 6-7 days.