I am scheduled to have an orchiectomy for chronic testicular pain on the 5th of February. I had a vasectomy for 11 years and got a reversal done 3 years ago in order to have my beautiful daughter. Shortly thereafter my left testicle started to ache. My urologist suggested a dennervation or a single orchiectomy but inwas reading up on dennervation they didnt seem to yield the results most people wanted. So I was convinced an orchiectomy was best. I am having second thoughts at this 11th hour and wanted to check the temperature of the room. I don’t want to be in this pain but I also don’t want to create new pain either. Has anyone regretted having the procedure ?
Did you have any pain before your reversal?
No, none. The pain didn’t start until 2 years after the reversal. I’m thinking it has more to do with diabetic neuropathy because I do experience pain occasionally in my feet.
I am likely going in for an orchiectomy with Dr P by March. That’ll be 6 months of idiopathic scrotal pain for me, and I too have had enough. I am simply not willing to live my life thinking about it 24/7 - not riding a bike, not going to ball games, worried about sex. Screw it!
As far as your options, while it seems counter intuitive I think radical orchiectomy is the least risky. Have them do a clean cut and cut the cord. The other two options are very scary. Epididilectomy almost always fails - hematomas and no place for the sperm to go, creating pressure pain. Denervation, well it could work, but if it backfires, it usually manifests as referred pain in the leg or hip, or the other testicle. Now you’ve got big problems that can no longer be solved with one sided orchiectomy. Neuropathy is no joke.
So no, I don’t think you’re jumping the gun. Testicular cancer survivors who lose one go on to live a perfectly decent life.
Ok I can respect that.
Dynamics of hormonal disorders following unilateral orchiectomy for a testicular tumor
Paweł J. Wiechno
Testicular tumors and their treatment interfere with homeostasis, hormonal status included. The aim of the study was to evaluate hormonal disorders of the pituitary–gonadal axis in men treated for testicular tumors. One hundred twenty-eight men treated for a unilateral testicular tumor at our institution were included. The hormonal status was prospectively evaluated in 62 patients before orchiectomy, 120 patients 1 month after orchiectomy and 110 patients at least 1 year after the treatment. The concentrations of human chorionic gonadotropin (hCG), testosterone (T), estradiol, luteinizing hormone (LH), follicle-stimulating hormone (FSH) and prolactin were measured. The clinically significant testosterone deficiency was defined either as testosterone <2.31 ng/mL or testosterone within the range of 2.31–3.46 ng/mL but simultaneous with T/LH ratio ≤1. Changes in hormone levels were significant: LH and FSH rose in the course of observation, and the concentration of hCG, testosterone, estradiol decreased. PRL concentration was the lowest at 1 month after orchiectomy. In multivariate analysis, the risk of the clinically significant testosterone deficiency was 0.2107 (95% CI 0.1206–0.3419) prior to orchiectomy, 0.3894 (95% CI 0.2983–0.4889) 1 month after surgery and 0.4972 (95% CI 0.3951–0.5995) 1 year after the treatment. The estradiol concentration was elevated in 40% of patients with recently diagnosed testicular cancer and that was correlated with a higher risk of testosterone deficiency after the treatment completion. Hormonal disorders of the pituitary–gonadal axis in men treated for testicular tumors are frequent. The malignant tissue triggers paraneoplastic disorders that additionally disturb the hormonal equilibrium.
This study is exactly what my wife fears the most.
One thing I’ve not yet been able to figure out, is how testosterone treatment is done after bilateral orchiectomy. T levels will drop to very low, that seems obvious. But - in practice - what kind of regime do patients use, and will they get a normal serum-T level and normal quality of life from TRT. I’ve read that it can be troubling to get a high enough T-level in the blood. Testosterone patches won’t give you enough, and injections will give big fluctuations.
AFAIK this doesn’t apply to unilateral orchiectomy, where it is said that the remaining testicle will compensate.
STK im on TRT unrelated to orchiectomy. There are creams you can apply daily to prevent fluctuations. I myself, inject 2-3x weekly to keep my levels stable. If a doctor prescribes pellets or asks you to inject any less than 1x weekly, run as far as you can and find another doctor. The key is the stable levels.
Its also been proven that low testosterone gives more medical issues than someone with testosterone in the upper of the normal range. The key is you are keeping yourself in the range the human body produces. As soon as you start adding anabolics and estrogen blockers, thats when you run into problems.
I can show you studies. There’s a great Facebook page headed by doctors that I use, TRT and Hormone Optimization. They also have a YouTube channel.
Right right. Understandably so.
What kind of T injection do you use? Where I live, the only T injection that have the cost refunded for patients, is Nebido. It’s supposed to be one injection of 1000 mg / 4 ml every 10-14 weeks. Testosteron-Depot(T-enantat) is possible to import, but at a much higher cost.
When you inject 2-3 times a week, do you inject small amounts from one glass yourself? Subcutaneous or intramuscular?
I am using testosterone enanthate, I rotate areas on my body and switch between IM and sub q. They say IM is slightly better for absorption, I rotate between stomach sub q, and glute and thighs IM.
Im not too educated on Nebido, but guys on that forum use it and im sure they can answer your questions.
Basically the science behind your frequency of injection is based off of something called your Sex Hormone Binding Globulin (SHBG). So if you’re like me and your numbers are lower within the range, your body does best with injecting more frequently because SHBG is what the Testosterone binds to in your body. SHBG is the car that transports testosterone through your body. Guys with SHBG on the higher end can get away with 1-2 shots weekly.
I had natural testosterone levels of 6 (8-28) and my doctor tries to keep me at 28. With 3x at 120mg weekly I bounce between 22-25 currently, so he just upped my dose to 130mg to hopefully get me to be like 25-28 or so. If you inject less like twice weekly you will be like 20-28.
My biggest fear is, after starting TRT, remaining testicle stop producing T and start to shrink. I read several posts about this mechanism in TRT forums.
Daveydealz what is your situation?
This issue comes up alot with men who suffer from hypogonadism.
The answer is, if you were feeling nasty enough and suffering from all the symptoms of low testosterone in the first place, why would you want to come off of it and start to feel shitty again? It’s a lifetime commitment. You wouldn’t ask a diabetic to stop taking insulin.
My nuts have barely shrunk any, and im going on 1.5 years. You can take something called HCG if you want to keep them pumped up.
Also, you can do something called a post cycle therapy with drugs like Clomid and HCG to start your balls again. But why would you? To feel shitty again?
TRT has been the best decision I have ever made.
The problem is i am living in turkey and TRT is not common in here… also.there is no HCG in pharmacy. İt is not imported. And i cant order a drug from usa or europe…it is impossible. Only nebido is available… İt is expensive and out of insurance.
I didn’t regret either of them. Sorry for the late reply. Was on slow release Oxy and life was zero fun before mine. Had left removed then right between 2016 and 2017. Instant relief in both cases.
I inject testosterone once a week.
I started Cross Fit last year and am in the best shape of my life. I am 57 years old.
My whole life is back bigger and better. Ex who demanded I get a vasectomy is also gone.
I have no balls and not a single woman has ever said, “Oh God, I can’t be with you because I have to suck on balls!” I know their is one out there but she can find her soulmate which isn’t me.
I joke that it looks like a furry little hamster with a big stick if they want to know. I have a very average dick btw but it makes for good humour.
Compared to the abject misery I lived after 2014 my life seems surreal now.
I hope that helps but no I don’t regret it. Should have ripped them off myself sooner.
So are you saying remove both not just one. I have one nut that has shrunk and being advised to remove it. I am a long term PVPS victim. I am having difficulty agreeing to getting one removed. I read an article on vasectomy been the unkindest cut and I agree mine was pushed for as well
No, not advocating for both. I can only speak for myself. I had pain in both. When first one was removed it was the first time I had any kind of relief. I had a total of nine major operations. Reversal, nerves cut, Etc. Etc. Countless attempts at getting better through these surgeries and no real relief. It was a tremendously painful existence. Filled with hope each time then back to square one. When one was removed I still was in quite a deal of pain. Both gone life went from hopeless to not even thinking about it. It is hard to even think I lived in that hell at present. I have both removed and live a full and exciting life.
I have copied and pasted this from 2016. It is about my surgeries. The research done in Toronto has an 80% success rate. Quite different from what other studies have.
“ Really good. I had my second testicle taken out last Tues. Had my first taken out in April.
Immediately knew the nerve pain was gone in recovery. I always knew if they could just take them out I would be fine.
I had a long talk with Jarvi’s research person. Just talked about all the issues we all have and how the medical community doesn’t know how to handle us. The most interesting thing for this board is the success they are having with orchiectomy. 80% and higher satisfaction to total resolution.
Jarvi is very delicate. I bruised pretty bad from both surgeries with Dr P. The bruising started back at hotel. Not a knock on Dr P just made travel even crappier. Both surgeries with Jarvi I had minimal bruising.
He said this side had considerably more scar tissue and he had to work around some things. I am more sore from this surgery than the last.
With both surgeries he went through my scoutum to harvest testicle. My right side had a huge hematoma from the denervafion so he had to go through the scrotum to get it.
I asked him to do the same for this surgery. This was primarily due to travel on the plane. I found it considerably easier to fly without my stomach being cut. Something for others to consider if you are traveling a long distance.
I asked him what he would do vs. an Alberta urologist and he said it mainly comes down to his knowledge of the nerves.
All I know is I am very certain my life is getting back to the best level of health I have had since this all started.
Not having relentless nerve ball pain sure is nice. Still have pain form the cord cut but that was greatly diminished today. Went to see doctor about a 30 min drive hit some bumps and wasn’t bad at all.
I don’t know weather to scream, pray or many other things. I am kinda in shock a bit. Every surgery helped but now I have no nerve pain on either side.
Glad for that because there is nothing left to cut.
You are in great hands at Mt Sinai”
Went to my urologist today and he figured out my pain was coming from my epididymis so I won’t actually need an orchiectomy…yet. the ultrasound even shows the tender area.