I had my orchiectomy surgeries a couple of years apart due to medical necessity (2007 and 2010).

I had a scrotal reduction but had post-op complications. I would like to get it revised but it is difficult to find surgeons near me.

I reduced T replacement for a number of years and I had issues will NAFLD as well as body shape. So I had to restart T replacement in 2020.

My wife had a very traumatic radical hysterectomy back in 2010. So we have been totally sexless since February 2012.

I think that denervation of the penis would increase my quality of life. Now I get woken up in the night by extremely hard erections.

Of course, penectomy is another option but honestly, it is convenient to stand to pee while traveling. Also, penectomy without medical necessity is almost impossible here without being diagnosed as trans. Since I have no interest in going female that is not a realistic option.

Any ideas or comments are welcome. Especially if anyone has had the procedure.

I have not heard of anyone here getting that done by 'official' medical care, so it may be a hard problem (no pun intended) to get an MD to fix... There are a fairly large number of folks that have used a variety of 'do-it-yourself' methods, but I can't suggest or recommend any, and EA policy is that we advise against trying these things at home...

Have you had any conversations w/ trans-gender centers RECENTLY? Since they released the Standards of Care v.8 last year, they now have a specific chapter on the 'care and feeding' of eunuchs and more options than just 'going female'. Unfortunately not all places have been good about moving to the new standards, I'm not sure about how Japan is. I know there are other countries in the region that also do surgeries so medical tourism may be an option...

Another option you MIGHT consider (and again a TG center would be the best place to find a doctor that would work with you on it) is to switch from T to Estrogen... Both hormones do similar things in terms of physical and mental health, but E will almost certainly stop the erections... It will cause some feminizing, most noticeably breast growth, which might not work given what you said about body shape issues, but it might be worth considering... (it is what I'm doing btw)

WheelyFixed

You could try 5mg of Finasteride. It might reduce the firmness, the frequency and the duration of your erections. It also should reduce your libido so that your desire for sexual relief is diminished too.

Thanks for your reply,

I am in Japan so I don't have the resources that you might have in the West.

I considered E a while ago. I am not sure I want to try that though. I am not interested in feminization. Just being neutral.

We seem to be in a very similar situation. My wife is also asexual. I constantly have trouble sleeping because of nocturnal erections. I am therefore going to ask the surgeon who is going to perform my castration whether he can cut the dorsal nerve of my penis during the planned operation. I am hoping that this will lead to permanent impotence. As far as I know, cutting the dorsal nerve should be enough to keep my testosterone levels very high and my penis permanently flaccid. We are welcome to exchange ideas.

Castor (imported) wrote: Tue Nov 14, 2023 4:09 pm We seem to be in a very similar situation. My wife is also asexual. I constantly have trouble sleeping because of nocturnal erections. I am therefore going to ask the surgeon who is going to perform my castration whether he can cut the dorsal nerve of my penis during the planned operation. I am hoping that this will lead to permanent impotence. As far as I know, cutting the dorsal nerve should be enough to keep my testosterone levels very high and my penis permanently flaccid. We are welcome to exchange ideas.

Denervation will not affect your ability to get an erection. That is controlled by nerves and muscles inside at the base of the penis, under the prostate. Denervation will have a lot to do with obtaining an orgasm due to loss of feedback to the brain. I've lost the nerves for both functions and sometimes it feels like my cock is starting to fill. But it isn't.

Hardball (imported) wrote: Fri Nov 24, 2023 4:10 pm Denervation will not affect your ability to get an erection. That is controlled by nerves and muscles inside at the base of the penis, under the prostate. Denervation will have a lot to do with obtaining an orgasm due to loss of feedback to the brain. I've lost the nerves for both functions and sometimes it feels like my cock is starting to fill. But it isn't.

Perhaps a misunderstanding. I meant the nerves at the base of the penis, not in the penis itself – that doesn't help. It is well known that this effect, which is called cavernous nerve injury (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8714392), is a very frequent result of poorly performed prostate surgery, where patients become involuntarily impotent because the nerves have been injured. However, I forwarded the question to my urologist/surgeon because I was interested in whether it would be possible to cut the nerves at the base in order to achieve voluntary impotence. It would be, as Wellesley says, an alternative to penectomy.

Here is the answer from my urologist: "TRT should be chosen so that your testosterone is in the lower normal range. This means that you should not expect increased erections or libido. Naturally, there is no guarantee of this. If we compromise the vascular-nerve bundle during the operation, which would be technically possible, there is a great risk of loss of sensation in the glans and even necrosis of the glans (because the blood supply to the glans can also be damaged). I would therefore not recommend this."

In other words, he advises against it because parts of the penis may otherwise die off. He advises keeping testosterone levels low enough after castration so that health is not affected, but no or only a few erections occur.