Who has had an orchiectomy (orchidectomy in the UK)

Discussion in 'Underwear, Clothing, and Appearance Issues' started by Dave NoCal, May 26, 2008.

  1. Dave NoCal

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    At the end of February I had a crushing injury to one of my testicles. First it swelled and now, as it has gone down, it's volume is reduced by about 70% and it is very hard. Ultrasound shows it still having blood flow. A local family practice doc believes that, while major blood supply was maintained, internal micro-arteries were crushed which caused the inside to die. He said that he doubted anything can be done to repair it and that it will probably not require removal for medical reasons. I'm not so sure on either count and am seeing a small town urologist on the tenth of June and a big city, BIG medical school urologist on the eighteenth.

    I went to the ER three times and it was only on the third visit, more than seventy-two hours after the injury, that an ultrasound was done. Exploratory surgery was never brought up. I think this was probably malpractice but am focusing on the medical issues right now.

    It still aches and if all it's going to do is sit there, hurt, and look and feel deformed I'm not sure I want it there. If, on the other hand, it's still making testosterone and there is no medical reason for it's removal maybe it should stay.

    If you have insights on what can and should be done, including what the surgery is like, how prostheses are implanted, how natural they look and feel, etc... your comments will be appreciated. Thanks.

    No, it has not been an easy spring.

    Dave
     
  2. B_CBTallthetime

    B_CBTallthetime New Member

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    how is it deformed? swollen?

    Any chance that in the future if parts of it just die, that it won't hurt?
     
  3. erratic

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    A friend of mine had testicular cancer and had to have one removed. It was major psychologically for him, but he said the surgery itself was pretty minor - except that he had to be ginger with the area for a while. He chose not to get a replacement, but only because he didn't want the expense of it. He said you get to match them according to size and that otherwise you would never know it's fake.

    I also know some trans women who have had orchidectomies and they described it as pretty simple surgery, and they've all had other surgeries, both plastic and necessary.

    Best of luck, dude.
     
  4. Dave NoCal

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    Thanks, guys. CBT, it's small and of lesser diameter, more like an almond than a pecan.

    Of particular interest are:
    1. Location of incision.
    2. Specific product used eg. saline filled or Soft Solid Testicular Prosthesis (which I think is still in clinical trials).
    3. Can prosthesis be placed within the tunica vaginalis so that it remains connected to the cremaster muscle and behave naturally ie. pull up when cold lower down when warm and keep the silicon away form the testicular wall.
     
  5. dickman45885

    dickman45885 New Member

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    Dave...Good questions and best answered by a specialist. Are you near a teaching hospital...those guys seem to be on top of everything. If not check with your local medical association, or local med school if you are near one. You might also check with web md. I would also do a check for any online support groups, might be able to answer your questions. Best of luck.
     
  6. jason_els

    jason_els <img border="0" src="/images/badges/gold_member.gi

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    Hey Dave,

    One area I can help you with is in what use it is to you to keep it. Testosterone production is regulated by a gland in the brain. It monitors your testosterone production and tells the boys to crank out more or less as required. This is why your testes shrink when you use external testosterone sources. The brain sees the testosterone, thinks it's coming from the testes, and tells them to cut back production.

    In your case, your brain will always strive to have what it thinks are the proper levels of testosterone whether you have one testicle or two. What happens is that your remaining testicle would simply kick into overdrive and produce enough to meet that goal. They can do this, and in nature's wisdom, are designed to do this in just such an event. As you likely know, your fertility should not be affected either. So if you have only one testicle, you will still be just as fertile and have just as much testosterone as if you had two.

    Also keep in mind that with the advances in replacement parts going on, it's entirely possible that you will be able to replace that testicle with a completely healthy new one at some point in your life.

    The replacement testes are just dropped into the scrotum. They're not attached to any of your musculature. The replacement won't be effected by your cremaster muscle, but it will ride up and down with the scrotum as is tightens and loosens. They appear very natural though some men report they don't feel all that natural. Fortunately, you can get the prosthesis implanted or removed very easily at any time.

    What ever you decide, I hope that it works out as best as possible for you and you have my support.
     
  7. Dave NoCal

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    Thanks, Jason.

    You have confirmed something I thought to be the case. That they usually just drop it in. In cases of testicular cancer, and testes that are simply missing, the architecture for suspension isn't there. In cancer cases this is because they pull the testis, epididmus, and the various tubing through an incision in the lower abdomen, clamp the tubes and, presumably, veins and remove all of it so to try as best as possible to leave no cancer behind.

    However, the VA has been doing epidimus-sparing, tunica vaginalis-sparing orchiectomy to control hormonal stimulation in cases of prostate cancer for quite a number of years. The way I understand the abstracts I read is that they remove the testicle from its casing and then fashion a spheroid implant from the patients' own tissues and place it back in the casing. Thus the fake testicle is suspended in the normal manner.
    My guess is that they were using the patient's own tissue because implants were taken off the market due to concerns about silicon. If implants had been available, cost saving might have been another issue.

    About five years ago, a company named Mentor got FDA approval for a saline filled implant. Currently, the same company has a different device, one that is filled semi-solid silicon in clinical trials. So, I was wondering if a similar approach could be taken with a silicon implant. I have appointments with two different urologist, one local and the other is at a major teaching hospital.

    Since my injury actually took place when I was in the care of the local hospital's staff and then the care appears to have not been up to standard, the local urologist who operates at that hospital may have an agenda separate from what is in my best interest. So, it will be interesting to hear what he has to say compared to the medical school urologist. This second doctor's specialty is surgical repair of genital trauma.

    Dave
     
  8. SCSea

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    I've had a number of opportunities to examine the cosmetic results of four conventional/unattached reconstructions (three single, one double), and other than one case where the implant was off-sized, I think the aesthetics of the reconstruction have been very good. Additionally, I've seen at least one friend with reconstruction in VERY cold river water, and the result was indistinguishable from normal anatomy to the casual observer. (There was slightly less scrotal wrinkling on the affected side). All of the reconstructions have been done in the last 2-10 years (testicular cancer, penetrating trauma, crush trauma and cancer, respectively.

    I'm all for preserving natural anatomy, but I'd hate going through life with constant low-grade groin pain.

    E
     
  9. Dave NoCal

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    Cubby, do you have any sense of whether removal will be recommended, given what I have described, or any other comments and/or descriptions.
    Thanks,
    Dave
     
  10. jason_els

    jason_els <img border="0" src="/images/badges/gold_member.gi

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    Dave,

    If you are thinking of consulting with a lawyer, do it before you go back to the first urologist at the hospital. The follow-up could be construed to mean you have faith in their standards of care and that could be used against you.

    I wasn't aware of the new implants. If they can do that and preserve the ancillary organs, I'm just amazed. I think that's wonderful!
     
  11. Principessa

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    I'm sorry you have had such a wretched spring. :frown1: However, it's amazing how much I learn on this site. :eek: I did some googling and found some interesting info.

    I can understand your displeasure at the current asymmetry; but I would hesitate to remove a body part that is still functioning in the interest or aesthetics. It seems the Mentor saline testicle implant is very popular; which makes sense as they are the #1 company for breast implants as well.

    The pain however is another issue. It seems they should be able to do something to eradicate your pain w/o surgery. :confused: If not I would go for the surgery. As Jason says the other testicle is designed to make up for the loss of the other.
     
  12. Principessa

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    I'm sorry you have had such a wretched spring. :frown1: However, it's amazing how much I learn on this site. :eek: I did some googling and found some interesting info.

    I can understand your displeasure at the current asymmetry; but I would hesitate to remove a body part that is still functioning in the interest or aesthetics. It seems the Mentor saline testicle implant is very popular; which makes sense as they are the #1 company for breast implants as well.

    The pain however is another issue. It seems they should be able to do something to eradicate your pain w/o surgery. :confused: If not I would go for the surgery. As Jason says the other testicle is designed to make up for the loss of the other.
     
  13. suineg

    suineg New Member

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    Dave.... I had my right testicle removed 14 years ago, I was 20, for similar reasons, impact injury and subsequent atrophying of the testicle. I luckily was at Ohio State at the time and had good doctors and good insurance. Basically there was not much they could do to repair it, and two different doc's told me that it would possibly be and increased cancer risk if left in.

    The doctor removed the testicle through the scrotum, little or no scar remains. I passed on the prothesis, as it were not approved then, and the problems with all of the breast implants freaked me out. Only having one nut hanging around didn't give me a problem with the ladies, after I overcame my feelings/shortcomings, and besides, it left more room in shorts for my other attributes. No issues with testosterone either. Still have my muscle mass and I have a daughter. It is actually amazing though, after so long, the remaining testicle takes over all of the functions of the missing one and increased in size. My urologist is impressed, as it is at the above the high end of his chart for size. BTW, they don't make the fake ones near that big!!

    Let me just warn you though about the after surgery pain I had. About a year after the surgery, I started having pain above my left testicle. Come to find out, any surgery in that area can cause orchalgia, in my case chronic orchalgia. I spent the following 13 years with off and on pain in the nut, and not just any pain, severe hunched over in the bed pain. However, after several ER visits, countless Oxycotin prescriptions, acupuncture and nasty herbal medications from witch doctors, the cure it to not wear boxer shorts. Stick with tighty whities and jock straps and give the remaining guy the support it needs. I am thinking the increase size weight may have been the cause!! For further info on that, visit: PAIN IN THE TESTICLES &#8212; Embarrassing Yet Useful Information For Masculinity Gone Wrong

    Good luck, and if you need more info support. I am here.
     
  14. B_dxjnorto

    B_dxjnorto New Member

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    Dave very sorry to hear about your injury and subsequent need of implant surgery. A friend of mine had testicular cancer, had the offending testicle removed, an implant placed and continues to have normal genital function if that's any help.

    How the heck does something like this happen when you are in hospital care? :confused:
     
  15. Dave NoCal

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    Thanks, guys. we will see what happens. Jason, that is a good point. Maybe I'll cancel the appointment with the local doc, or at least postpone it to after the big medical school docs have their say. In a way, even seeing the local doc is kind of pointless because I don't think I would consent to a planned surgery at that hospital. They have had a lot of problems in recent years including fights between the attending physicians and the administration. At one point, the anesthesiologists were refusing to come in. Then the orthopedists went on strike. Lately it's been the neurologists. There were a couple of PCA deaths. They have a new administrator who seems to be a much needed improvement but chronic problems such as I have described and animosity between the hospital and the physicians take years to resolve.
    Suineg, I have already figured out the jockstrap thing. I guess they are coming back!
    Dave
     
  16. Mickactual

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    Dave - I can answer at least one of Your questions:
    To the best of my knowledge, an implant incision is made in the pubic area. This is a major plus: naturally they shave You to perform the procedure, but once Your pubes grow back in, the scar is very unlikely to be visible.
    Good luck bud.
     
  17. dickman45885

    dickman45885 New Member

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    Dave....

    Kind of an analogy to a car wreck. Some one hits your car but you take it to the body shop of your choice and let them pay for the damages....

    They hit you....you go to the body shop, doc and hospital of your choice, and let them pay for it.

    Good luck in getting it all straightened out and getting the physical problems resolved. I would not let them rest....and I would make sure I have a very good, read best, malpractice attorney I could find.
     
  18. Dave NoCal

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    Thanks again.

    Mickactual, scars don't bother me so long as they are tidy. My question about the location of the incision is more a matter of curiosity.

    Dickman45885 and Jason, yeah, the whole thing is a mess and it seems pretty clear that the hospital fell far below standard of care. I was brought in from a remote location by helicopter. Right as they were getting me into the helicopter I started having large involuntary movements. They looked like seizures but my awareness was that I felt very cold and was "shivvering" in an exagerated way. The terrainwas rough and I may also have been jostled. from the waist down. The gurney had straps that buckled between the legs and my ball got between it and my thigh, I guess.

    Now, you would think that when a guy come in by helicopter, has numbness, and involuntary movements the medical staff would undress him and at least look him over. Wrong. They took my shirt off to hook up a heart monitor but notmy pants of underwear. They kept pumping me with morphine and muscle relaxants, As I regained sensation, I complained of testicular pain but they brushed that off and sent me home with no exam of that area or sonogram.

    By morning, my scrotum was very swollen and very painfull with visible bruising on the exterior. I went back and they gave me a prescription for Narco and sent me on my way. I overheard two doctors talking about me and they said that, to get an sonogram, they would need to call in a technician. So they passed. Two days later I was still in a lot of pain and went back. I finally got an sonogram and some lab work. The ultrasound report stated that there was blood supply so they gave me a prescription for Levaquin and sent me home.

    The sonogram was over seventy two hours after the event. My understanding is that immediate ultrasound is the standard of care and, if there is any doubt, emergency exploratory surgery needs to occur.

    There, that's my rant. Four different doctors had the opportunity to do the right thing. None did and now it appears probable that I have lost an organ. It may be that it couldn't have been saved, but they took no steps to find out. Yeah, I'm going to find an attorney.
     
  19. dickman45885

    dickman45885 New Member

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    Dave.....

    WTF....these guys did graduate from med school.....they did not want to call in a tech.....

    Get the BEST Malpractice attorney in the state.....he will hear you out, tell you if you have a case, and if he takes it, take a percentage of the claim....

    go for it.....in the words of all us famous Americans.....Sue the bastards.....and take them for what you can....you deserve it. fuckers
     
  20. jason_els

    jason_els <img border="0" src="/images/badges/gold_member.gi

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    What dickman said! Holy shit! I thought this was due to an act of God! I had no idea it was due to gross negligence on the part of the EMTs and physicians!

    Hobble, don't run, to the best malpractice lawyer you can. Strangulated testes might be saved if the condition is caught in time. This is inexcusable! These assholes fucked-up. GO GO GO. All the money aside, don't let this happen to other men. Make the EMTS and hospitals be aware of their proper protocols or, if necessary, create new ones.

    I'm just too furious to say anything more. Godspeed Dave man.
     
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