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Do you remove the spermatic cord when you do an orchiectomy and why?

Do you remove the spermatic cord when you do an orchiectomy and why?  Am considering having an affordable orchiectomy and a preliminary step to my male to female sexual transition. Krista

Dear Krista,

Yes, during MTF orchiectomies we remove the spermatic cord up to the external inguinal ring.  If not done, the cord remnant has been called by some of my patients a “tootsie roll”.  No patient if given a choice (that of I know of) wants to feel that, on both sides no less.

In that the spermatic cord is the pedicle upon which blood supply enters the testes, this is also a good way to isolate the testicular artery and vein, and vas.

Anticipate you may feel a lump in the inguinal area for a few days to a week or so which eventually disappears and is typically not noticeable.  We use a limited vertical midline scrotal incision to remove both testes  A perineal compression  dressing is applied and we recommend a generous amount of bed rest for 2 days.

While we do use absorbable sutures.  Ideally they should be removed 2 weeks after surgery. Scrotal incisions usually heal very well.

Cordially,

Harold M. Reed, M.D.
The Reed Centre for Transgender Surgery – Miami
1-305-865-2000

 

Orchiectomy Example 2: Another patient status post orchiectomy and scrotal removal, unsure if she was ever capable of going all the way. P.S. she now wishes to have complete MTF and loss of scrotum poses no problem whatsoever. Hoping to post followup photos in a few months.

After photo of bilateral orchiectomy via vertical midline incision and removal of scrotum as well (as requested by patient).  The spermatic cords have been removed
as well (no “tootsie rolls”)

Orchiectomy Example 3: This patient had radical prostatectomy (by others) and is a slow- as-you-go MTF patient. Wanted initially orchiectomy and scrotal removal, then had breast augmentation.

After photo of bilateral orchiectomy via vertical midline incision and removal of scrotum as well (as requested by patient).  The spermatic cords have been removed
as well (no “tootsie rolls”)  Photo of another patient, same procedure.

 

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