Orchidectomy (testicles removal)
What exactly does orchidectomy involve? What happens during the operation and what happens during the recovery period? This page provides information about the procedure, the risks related to the operation, and the post-operative period.
About the orchidectomy
Orchidectomy is an operation during which both testicles are removed. The skin of the testicles is not removed. You may opt for this operation if you want to stop taking testosterone blockers and are not or not yet willing to undergo vulvoplasty or vaginoplasty surgery. Orchidectomy may be an alternative if your BMI is over 30 but not higher than 35. A value of more than 30 means that you do not meet the criteria for vulvoplasty or vaginoplasty, but, at not more than 35, you would still be able to have an orchidectomy.
After having had an orchidectomy, you will no longer need to take testosterone blockers.
Before undergoing surgery, it is important that you are well prepared. You can find additional information on preparing for your orchidectomy here.
The operation
The procedure will take about half an hour and is normally performed under general anaesthesia. An incision is made across the middle of the scrotum on the dark line that runs there. Subsequently, the testicles are carefully removed. The testicular cord is cut on both sides, after which the wound will be closed. The GIF below shows the steps of the operation.
Note that the details of the surgical procedure may differ for any Dutch care facility. It is, therefore, important to check the exact procudure with the institute where you are having surgery.Aftercare
In the first two weeks after surgery, you are not allowed to swim, take a bath or go to the sauna. This is to prevent the stitches from dissolving too early and the wounds from opening up. Brief showers are allowed. You are not allowed to exercise or lift heavy objects for six weeks, as this may cause bleeding or the build-up of excessive fluid.
Hormone use after the operation
After the operation, you will stop taking the testosterone blockers and will only continue taking oestradiol. Following the operation, your hormone treatment will be supervised by the endocrinologist.
Complications and risks during and after the operation
During or after the procedure, medical complications may arise — even though the operation was performed correctly. Possible complications during or after orchidectomy include:
- Bleeding (continued) immediately after the operation: If the bleeding does not stop on its own, a second operation may be necessary to stem the bleeding.
- Infection: Although the procedure is done in a clean and sterile way, there is always a chance of bacteria entering the wound. In the period after the operation there is also a risk of infection. That is why it is so important to take good care of the wound.
- Blood suffusion (haematoma): Some blood may accumulate in the surgical area, which may give the area a slightly blue or purple appearance, like a bruise. This will go away by itself after 2 to 4 weeks.
- Fluid retention (oedema or seroma). Fluid may also accumulate in the surgical area. If this feels uncomfortable, the fluid can be removed by the physician.
- Badly healing wound edges (wound dehiscence). After the operation, the wounds may not heal immediately, and may open up a little. Should this happen, we recommend that you rinse the wound thoroughly with running water and, if necessary , contact your attending physician.
Sexuality
Sex drive (libido) depends on the hormone testosterone – irrespective of gender. Because your body no longer produces testosterone after the removal of the testicles, this can affect your libido.
Your sexual life depends not only on genital surgery, but also on many psychological and biological factors. Learning more about your genitals by discovering what is sexually important and pleasurable to you are significant challenges following genital surgery.
In short, discovering what you like, on a sexual level, is important and so is discussing this with any current or future partner. The things to consider include whether you would like to have or already have a partner, and would you or do you talk to your partner about your sexual desires.
This text was edited on 14-10-2022
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Vulvoplasty
The vulvoplasty is a feminizing genital surgery that creates a shallow vagina. Here you can read all about the surgery and recovery period.
