Facing up to an Orchidectomy, also known as Orchiectomy can be worrying for many men.
There are three main reasons why you may be preparing yourself for or considering this surgery. Either you have been diagnosed with testicular or prostate cancer, or possibly you may suffer gender dysphoria.
Having had issues with my prostate and also suffered gender dysphoria for more than 90% of my lifetime, I hope this article will be able to give you at least some confidence about the surgery. A Ochidectomy (USA spelling) or Orchiectomy (UK spelling) does offer huge benefits.
Also known as an “Orchi” the surgery itself is relatively simple but I appreciate you may well be nervous. But before I go into my medical procedure a theme of my website is that “we are all different” so obviously my circumstances will be different to yours. And because I am trans I fully appreciate my opinions are slightly slanted.
At the age of about fifty-four, I started to notice my urinating habits were changing. At first, I found I needed a pee a couple of times a night, but as the years ticked by this increased to three or four times a night. Getting back to sleep was sometimes tricky, and often I found myself quickly re-awakening - in need of yet another pee.
That was not the biggest problem, though, which was the sudden desperation to have a pee.
I recall once driving on the M4 and passing Reading Services thinking I did not need to stop, but within 4 miles, the urgency set in and within another couple of miles I had wet myself.
I was in a difficult situation and did not know how to deal with this issue without public embarrassment. This scenario occurred several times, and cutting down on liquid intake did not make a huge difference.
I had also found that the quantity of pee that I was urinating was getting less and less, and I had started to measure in seconds how long I could pee for. The strength of my stream was also getting weaker and weaker, and I knew by then I had a nasty problem – obviously fearing prostate cancer which my dad had died of.
A PSA test, together with the dreaded prostate 'finger test' revealed otherwise.
I had Benign Prostate Enlargement, also known as BPE and my lovely female GP (yes, she did do the finger test, and she was very gentle) prescribed Finasteride and Tamsulosin.
Initially, this worked though the Finasteride takes some months to kick in. However, after a few years, the effectiveness did start to wain a bit, and for various gender-related reasons, I was also then prescribed three monthly Decapeptyl injections as well. Looking up what Decapetyl was concerned me and I wanted to stop this horrible injection as soon as possible.
But the urination issue was not my only concern.
As mentioned, my dad passed away because of prostate cancer. He knew he had it some fifteen years before he passed but was put on the “watch & wait” programme and never really made a fuss about it. On reflection, I wish he had kicked off about this but he did not.
The principle is, of course, you will die of something else before prostate cancer gets you, but in his case, he didn’t get anything else and watching him die via prostate cancer palliative care was far from easy for any of us.
I swore I would do everything possible to avoid prostate cancer but also knew because of my dad having it - I was at increased risk.
And then there were my gender identity issues which are well recorded on this website by reading the “My Story” page.
You would have thought given my age, that I had gender dysphoria, prostate issues and a concerning family history of prostate cancer that getting an Orchiectomy would be easy - but as my story reveals that was certainly not the case.
Orchi’s are not given out easily in the UK, in part because this is permanent surgery that can not be reversed. The surgeons appear to take the view (and I am sure most men do too) that losing ones “manhood” is a big deal.
So, while I appreciate, I am in the minority here can I just suggest it is not a big deal as you may think? Yes, I can understand if you are young, this is a problem - but prostate issues do tend to come later in life so for us older folk here is my reasoning.
Firstly, are men, as a sex really that great?
Men are seen as the vigorous dominate sex, but the truth is men live on average four years less than women. And then there is the issue of crime for every one woman locked up in jail there are twenty-two men.
Attacks by men against women (and indeed other men) are common and can result in family breakdowns and women having to seek refuge in shelters. As a sex, men should be ashamed that this occurs.
And then there is the issue of war.
My dad used to tell me religion & politics causes war.
I would argue that it is men’s (not women’s) interpretation of issues within religion and politics that cause war - and millions of deaths every century. In fact, one shocking stat is that in the 20th century at least 108 million people died in wars almost all instigated by men. 108 million is a big figure so breaking that down I make it 20,769 people per week, every week for a century.
Men as a sex, are therefore far from squeaky clean.
So, while I accept there are some lovely men around – I would suggest men (as a sex) have nothing much to be proud of.
As mentioned, I personally, despite having medical and psychological reasons had great difficulty getting my Orchiectomy and this nearly cost me my life due to suicidal thoughts. I am just sooo pleased now that I did not do it.
Having the surgery (once agreed by your surgeon) is a breeze, but I can offer any guy having this operation some personal tips.
I had a Bilateral Orchiectomy, and I would suggest getting rid of as much scrotal area hair as possible. I did that in part, by using a Philips Lumea IPL machine. Now the manufacturers say you should not use this machine on a scrotum, so I broke the rules here. I also had some mega painful electrolysis and of course, cut my pubic hair as well.
Now I accept I was ultra fussy about this, the surgeon will (as far as I am aware) shave the area of the incision and sterilize it, but I wanted to be ultra-careful.
My reasons were that I was very keen to avoid an infection which can then lead to a hematoma - a bleed into the scrotum. This takes weeks to clear up and is allegedly very painful. So keeping the scrotum area as hair free and as clean as possible makes sense. Regarding washing “my bits”, (both pre & post-surgery, I used Dermol Lotion, which is an anti-microbial emollient and gets rid of nasties much better than ordinary soap.
Surgery usually takes about an hour under a general anaesthetic and more often than not, is a day case. On recovery from surgery, there was no pain but certainly some swelling and a few drops of blood, but in the main it was easy.
The next day, yes there was a pain, but that was controlled with a strong co-codamol and ibuprofen. Keeping the wound clean is key to a quick recovery, and I was up and back to normal in about a week though of course, you must take great care not to overdo it.
So, would I have an Ochidectomy (Orchiectomy) again?
And the answer is yes – in a flash.
Since having my Orchi, I have found that I am more of a ‘human being’.
I love being in this position and not for one second do I miss my nuts that used to hang awkwardly (and sometimes painfully) between my legs.
On the medical front, I no longer take Finasteride and no longer have to bear those horrible Decapeptyl injections. I do still have to take the Tamsulosin capsules and know that I will be on HRT patches for the rest of my life.
I can live with this because the big bonus is my Benign Prostate Enlargement has “reversed”.
Because of the steps my health professionals and I have taken, my prostate has shrunk meaning I am peeing like a twenty-year-old. I rarely need a pee at night and can undoubtedly travel for hours at a time without the fear of peeing in my pants.
I know one day I will pass away, but my chances of that being by way of prostate cancer are reduced because my nuts are no longer pushing out any testosterone at all.
And here a word for any guy who has prostate cancer or testicular cancer reading this.
You can beat cancer and live a healthy life. Cancer treatments have improved immensely since my dad passed.
My other half (Jen) has beaten both ovarian cancer and perhaps one of the worst diseases possible – pancreatic cancer. My mum now aged 95 beat bowel cancer twice too. So while my dad did not make it, I only wish he had the option of an Orchi. I think it could have saved his life. My dad may well have said he did not want to lose his "manhood" but the truth is I and my family would rather he was still alive.
So if you are offered an Orchi take it – and if you are not perhaps, you should ask your surgeon to talk it over with you. Losing your balls is no big deal.
After all...we do it to animals in our care without a second thought.
Testosterone is not exactly a hormone that does men many favours and certainly causes humanity a fair bit of grief.
And if you are trans like me, then chances are you may well be desperate for an Orchi or certainly been giving it thought. All I can say is it has worked 100% for me.
My surgery was performed just over a year ago, and there are certainly no regrets on any front. I never suffered any unwanted side effects though I do understand some folks can. Do I miss intercourse? Not in the slightest and given Jen's medical history, she was not up for it anyway.
An Orchidectomy / Orchiectomy offers trans folk peace.
It is not a full SRS but if you are getting on in life, or want to use an Orchie as a staging post, grab it with both hands - and become a human being.
One quick note. If you found my article via a search engine and are not transgender could I ask you to quickly glance at my “Home” page and “My Story” page? Trans folk in the UK are having a bad time at the moment, and we need people like you to understand we are just ordinary people wanting to live in peace. The UK media gives us a tough time, and we are discriminated against.