(FAQ) Had an orchietomy. During vaginoplasty will you remove the spermatic cords?

Had an orchiectomy. During transgender vaginoplasty will you remove the spermatic cords? Sheila

Dear Sheila,

If you can feel the spermatic cords now (often referred to as a “tootsie roll“) surely, I will remove them, as the last question you want posed in an intimate situation is “what’s that?”  If I cannot feel them, I’d opt not to do a sub-inguinal exploration to find them, as all the surgical bruising adds up. Perhaps you could call your orchiectomy doctor and ask if they were removed.  That approach has been called “high ligation” of the cords.  This is the approach we use when doing a transgender orchiectomy.  Hoping this is of help.

Harold M. Reed, M.D.


testicle with spermatic cord going up and laterally to inguinal canal

spermatic cord

Spermatic cord entering inguinal canal with some traction on testicle in preparation for high ligation of the cord.

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