So I had a testicular ultrasound recently, due to a large hydrocele on one side - turns out I have them on both sides.

My doctor sent in a referral to the doctor she thought would be best for me to go to, who would be most likely to do hydrocele repair -and- bilateral orchiectomy at the same time, and do it well enough to not ruin my chances of future SRS, hopefully. She put it in the referral, the specifics of my situation and recommended orchiectomy alongside the repair. This is a real issue for me in that, I have a lot of testicular pain, but I'm only willing to -ever- let my scrotum be opened one single time. So if they won't do the orchi, I won't go for the hydrocele repair, because I don't want to have multiple surgeries on a body part that ideally would only ever have -one- surgery done to it for me, prior to SRS.

I want to keep my options for full SRS as open as I can, and having my scrotum cut open once is as much as I'm willing to do. I don't want to have testicles though, and I have no idea if I'll ever be able to afford SRS, and it's already been years since I started hormones, it would be nice to no longer have to worry about testosterone, UGH. F*** testosterone. Plus there is, you know, the pain. It would be nice to not have that going on anymore either.

My doctor is optimistic about it, I am very cautiously optimistic, kind of telling myself it's not going to happen so that if it doesn't happen, I won't be too disappointed. Ugh I hate the suspense.

I know it's impossible to know till I see him for the consult, which I already scheduled. It's a little under 2 weeks from now.

What do y'all think though? Do you think my chances are good? Or do you think I am in for disappointment?

I really hope it happens.

Sounds like the balls removal will hinge on if there is enough medical necessity to justify removing them or not ? Pain might be enough, especially if they have already atrophied from the hormone treatments you have been on for some time now.

Some drs will bend a little to give a man a free vasectomy while their scrotum is opened up for a different surgery, like a hernia or hydrcele repair. Maybe the dr might be willing to remove your testicles as a faster and easier surgery to empty out your whole scrotum ? That might be faster and easier to do, instead of doing more painstaking surgery to work around your balls to remove the hydroceles and save your testicles and all of the necessary spermatic cords and inner sacks and membranes needed for retaining your testicles and keeping them alive and healthy ?

Its worth asking him about it. It seems like removing everything from the scrotum with no worries of what to keep undamaged might be faster and easier for him to do.

The first thing to ask him about is if he already plans to remove your testicles or not ? If pain and atrophy are enough to convince him to castrate you ? Then ask about emptying your scrotum of everything ? And see what he says. Then you could shop around to other drs to see if they will remove your balls or not, since you get to pick which surgeon works on you.

Don t be too quick to rule out more than one surgery on your scrotum. The old scalpel vasectomies cut pretty big openings on both sides of the scrotum. Those healed up surisingly fast and easy for most men and would be similar to your hydrocele or castration surgery cuts.

cutnbulls2ox - orchiectomy was put through as part of the recommendation, it was recommendation from my doctor both for hydrocele repair and for orchi.

One thing I am thinking - what if the hydroceles are as a result of either the atrophy (which is quite extensive, they have shrank an incredible amount, and they were bigger than normal to begin with pre HRT*vomit*) or the fact that I tuck? When I tuck my balls just automatically go up into my inguinal canals - I imagine this probably isn't helping my situation? I have no choice really. It's kind of like, I put on the right type of undergarment, take like 1 second to adjust myself, and it's all tucked away. I'm not going to stop doing it, that would both limit me too much, and honestly, some stuff is just going to force the balls up there.

They'd be going up into the inguinal canals regardless.

As far as not ruling out any more than one surgery - it's an option I won't consider, and I have put considerable thought into it. I'm not risking it more than once, I'm not letting anyone operate unless either 1) they're taking my balls out at the same time or 2) it's a life-or-death situation, or something like that

My doctor was floating out of state options - so that could be potential backup and reason to refuse any surgery if an orchi won't be done alongside it.

In regards to even saving the balls at all, reasons against that I can give the surgeon:

They're atrophied and I plan on removing them eventually anyway.

They're not something that I -want- to function, and I actively take meds every day to make sure they don't function. So saving them is kind of backwards and pointless. "here let me save these doomed organs you've intentionally shut down"

Having an orchi would be a net benefit to my general health, because it would allow me to stop taking anti-androgens, which I have been doing for years.

The hydrocele could be because of the atrophy, or my tucking, etc.

I can deal with some pain. I already have to anyway because of other body parts that are fucked up. So if there is no orchi, there is no surgery.