Overview of the procedure 

Orchiectomy is also known as orchidectomy, a surgical procedure in which one or both testicles are removed (bilateral orchiectomy). 

This procedure is commonly performed as part of sex reassignment surgery (SRS) for transgender women. 

Preparation Prior To Surgery: 

 Medical history assessment (any allergies, serious medical condition and all 

medications taken both prescribed and non-prescribed), physical 

examination, and laboratory tests will be performed during consultation. 

 Avoid smoking   for about 3-4 weeks prior to surgery, as nicotine interferes 

with circulation and will greatly affect healing process. 

 Stop drinking alcohol, a week before the surgery and throughout your 

recovery period. 

 Taking any medications should be avoided such as hormones, anticoagulants, 

anabolic steroids and supplements at least 4-6 weeks to prevent complicating 

medical factors prior to surgery, and also avoid taking aspirin, anti- 

inflammatory drugs and herbal supplements as they can increase bleeding. 

 Psychiatrist evaluation stating that you are fit to undergo this type of surgery. Our surgeon required one certificate from your home country and one from Thailand. 

 HIV testing, our surgeon required HIV testing prior to the booking of your surgery. We accept HIV (-) clients only. 

During the procedure:  

    The patient lies flat on an operating table with the penis taped against      the abdomen. The nurse will shave a small area for the incision. After anesthetic has been administered, the surgeon will make an incision in the midpoint of the scrotum and cuts through the underlying tissue. The surgeon removes the testicles and parts of the spermatic cord through the incision. The incision is closed with two layers of sutures and covered with a surgical dressing. If the patient desires, a prosthetic testicle can be inserted before the incision is closed to present an outward appearance of a pre-surgical scrotum. 

Operation time: 

It takes 1-2 hours 

Type of Anesthesia use: 

This surgery is under local or general anesthesia 

Hospital/clinic stay: 

If surgery done under local anesthesia patients can go back home after the surgery, if surgery done in the hospital need to stay 1 night in the hospital. 

Days to stay in Thailand: 

At least 7-14 days. 

Risks and Complications: 

The biggest risk of an orchiectomy is hematoma (or bleeding into the scrotum).  It is very common for the scrotum to be bruised, swollen and tender for 2-4 weeks after surgery.  However, a large, purple-appearing scrotum can indicate a hematoma.  Hematoma can be prevented with a compressive dressing, tight-fitting undergarments and/or ice packs. 
 
Ilioinguinal nerve injury can occur if the nerve is damaged during dissection of the spermatic cord.  This is more common in men who underwent prior inguinal surgery (usually for an undescended testicle or hernia repair) and can occur during dissection or be inadvertently trapped in the closure of the external oblique fascia.  The deficit is often decreased sensation to the medial thigh, scrotum or base of the penis.  It is often transient, but can take several weeks or months to improve. 
 
Inguinal hernia can occur if the external oblique fascia is not closed properly or if the closure breaks down.  It is important to minimize strenuous activities for 2-4 weeks to prevent development of a hernia.