I suffer from hypogonadism and have had low T levels (low 200s to mid range 100s and one test as low as 75) for nearly 20 years. I also suffer from frequent low grade testicular pain (mainly in the left but also present in the right) and discomfort. I do have a regular urologist who helped me get Testim approved on my insurance by writing a letter of necessity to them stating that I am chemically impotent because of the low T levels and that HRT is needed in my case. While Testim did raise my T levels it did nothing for the discomfort I often feel. My testicles are smaller than normal but appear healthy otherwise when examined. I have not discussed castration with my urologist I guess out of embarrassement about it but I do wonder if it would end my discomfort and pain. I hear it is nearly impossible to get a doctor to remove a man's testicles short of cancer but do any in this group have any ideas if my situation is worth asking my urologist about?

Also I might ask if I do decide to pursue trying to get my doctor to remove my testicles is there anything I might add or bring up when presenting my case to him that would persuade him to do the deed?

As a person who suffered from varying levels of pain for many many years, i can tell you that urologists do not like to remove what they perceive as healthy testicles. It is a real battle. My advice to you is to go to them well armed with information. Start and keep a diary of the pains you have, when they start , which side and the duration of the pain. Gather from your present doctors information on your long standing low Testosterone. Make a list of any and all treatment attempts which have been used to try to end the pains. I would also suggest that you see a chiropractor and get him to check your lower back and take X-rays. This will help to verify that the pains are not related to any irregularity in the neural pathways.

Armed with this information, seek out a female urologist in a large urological practice. A larger practice will tend to be more motivated toward surgeries, and a female urologist will not have the OMG (grab their own balls) reaction that many male urologists would have when you suggest a possible long term cure is removal.

I will assume at your age, that additional children is likely not on the horizon, so fertility is not an issue. Additionally if you are here asking questions, it is also pretty clear that you have no emotional issues with the idea of not having testicles.

You must make quite clear to any urologist that youi see that A., you are in pain, and it affects quality of life, B. That you are quite aware of the dependancy on HRT and are already doing that. C., That you are quite comfortable with the idea of not having testicles, and feel that there would be no negatives that you can see.

Following the above outline is a good start to getting to some serious discussion regarding removal. If the first urologist you see is not at least open minded then get a referral to another. You are entitled to get multiple opinions when you have a medical issue, and insurance will pay.

Raymar

Thanks for the info Raymar. All you said is very helpful in arming myself to seek this result.

I certainly like your idea to search out a female urologist because of her not thinking like a male in regards to losing their balls. Makes perfect sense that a female would be far more inclined to see removing my testicles as a viable solution and advance the process directly rather than waiting more months or...ack... years down the line.. I would prefer to use my current doc BUT will keep this idea at the top of my list if he refuses to openly and seriously discuss removal.

I also think it a great idea to seek out a large practice as well because of the pushing surgeries issue more so that a one person office. I would never have thought about it in that light.

I really hope to hear other ideas or views from any and all EA members concerning this topic. Share from your personal experience or just open ideas.

I am looking for all suggestions.

I agree with everything Raymar said.

Female and younger urologists tend to have less issues.

I also think when the doc is out of their own options they are more likely to listen.

I absolutely agree with Raymar. I could not find anyone to do it despite my problems of deformed unmatured testicles and low T count. I did finally get my orchiectomy through a doctor I heard of right here on EA that would do it. But this probably did come at a much higher price though.

Took Raymar's advice and have an appointment with a female urologist in a couple of hours. I'm anxious to see what she thinks.

<rant>Yes. I had pain for many years from this, before finding a dr who would do the right thing. Yes, it cost far more than it should, and it was not done to the best standards. Life is better now.

The very existence of this thread calls into question the criteria of medical practice. Do US MDs fear peer pressure more than pressure from patients asking for the reasonable -given the circumstances? US medicine appears to run on rails laid down a long time ago. Off topic here to continue, but IMHO needs airing elsewhere.

We know friends with positive experiences of medical tourism; maybe this is another encouragement of such surprisingly inexpensive travel.</rant>

I feel better now!

Having suffered from testicular pain since 2004 as a result of a hernia repair that damaged the left testicle all I have ever been offered is pain killers. In spite of the fact that last year the epydydimal cyst caused by the surgery gave me a prostatic abscess due to an infection from the testicle and spread to the other testicle. Even after recovery all my doctor would do is offer me pain killers.

Since then I have probably killed them with alcohol injections and guess what the cysts are now tiny and cause much less pain.

There is no doubt that the medical community does not recognise what many us go through.

I have my own gender dysphoria to deal with too. This aside testicular pain can drive you to despair and I have done all kinds of crazy things to my testicles because of the pain.

So getting the issue out there and openly discussed would be amazing. However, just think about prostate cancer and the difficulty in getting men to talk about it.

When I have spoken to friends about prostate health as a result of my issues they kinda go weird on me.

The biggest problem is getting over the holy reverence we humans have and the need to bow down to the orbs of pro-creation. To that end female urologists are probably more sympathetic as they will not feel the pull of their orbs as they contemplate the issues. Let's face it when we see someone get one in the nuts we all either reach down or grimace in sympathy.

I wish you well and I hope you can find a way of dealing with the pain in a safe way.

I know when mine hits me it goes from testicle right up the inguinal canal and thumps me in the kidney and then aches for hours on end.

I have had this for well over 25yrs and can not get a doctor to remove my testicles they say i will just need to live with it so if you get a doc willing to do it good on you and go for it