The Big O day: my orchiectomy

by Robyn Browning

 August 8, 2001 Wednesday

Today I took shower when I woke and scrubbed my genitals with Betadine scrub as Dr. Barham asked me to. Then I got dressed wearing a pair of pants I knew would be easily removed and comfy to wear after my family jewels were removed.

I piddled around at work until about 10:30. I read the book I got from a friend "Urologic Surgery" and found that the section that covered the radical orchiectomy was just one page long.

My fiancée, Georgiana, messaged me about 10:30 and asked how I was doing (emotionally/psychologically). Instead of sending a return message on the computer I called her on the phone and told her that I was doing really badly, and started to huff like I was about to break down and cry and I acted as though I wasn't sure that I could go through with the procedure.

She replied to hearing this with "Oh, baby..." in a tone of sympathy. I abruptly interrupted and said "Nah, just kidding." I followed explaining that as the last couple hours counted down that I was really fine with the procedure and ready to get it over with. We talked and finalized our plans for lunch. I had expected to be nervous, but as the time approached I felt ready and sure.

Karen from downstairs came up for a rest break and gave me a hug wishing me good luck on the orchi. That was really sweet of her I thought and I wished her luck on her upcoming IUD procedure.

Georgiana and I met at 12:00 for lunch. I carried down a bunch of stuff from the office I thought I could work on while I would be recovering. We went to Big Town Hero and grabbed lunch. We walked over the two blocks from my office to the water front and sat down to eat under the large shade trees.
While we ate I took my Valium that I had been saving for two months. I was going to smoke some pot too for extra relaxation but we forgot the lighter. I had read accounts of this procedure being very discomforting and painful. I was not looking forward to that part.

We then drove over to Dr. Barham's office. It was only twenty mintues from my office. I told the receptionist my name and that I had an appointment. She knew instantly what I was there for. I also said that on the phone when I made the apointment to remind the nurse 'something about a pill before hand'. I knew it was another Valium.. hey the more the merrier, I thought.

G and I sat down and a couple minutes later a blonde nurse came into the waiting room with a pinkish pill and a glass of water. I swallowed it down too. Yum... Valium. By this point I don't think passing tornado would have phased me. I was feeling really mellow.

It wasn't even ten minutes and the nurse poked her head out the door and called for "Robyn".  Hmmm, that must be me.. the old guy to the left with the urine bag doesn't look like a "Robyn". I asked if Georgiana could accompany me and she said it was Ok.

So George and I walked down the hall to the room where it would be done holding hands all the way. We sat in the two chairs that were in the tiny room. We were left alone for a few minutes. There was a window, a table and drawers in front of the window, a medical table with stirrups and white towels wrapped around the knee part of the leg stirrups, two chairs in which we sat. To the left was "the table",  a surgical pack wrapped in blue fabric fresh from the autoclave sat on small stand at the foot and to the side of the table.

I got up after a minute feeling a bit fidgety and peaked into the drawers... seeing if there were any cool medical toys to play with. G verbally shunned me for being curious. About the time that I shut the drawers and sat down Dr. Barham came in followed by a nurse. He greeted Georgiana, sat down on the stool at the end of the table and asked if 'I was ready to do this'. I replied to him that I would not be sitting here if I was not ready and smiled broadly to him. Honestly, I almost felt like his question was a joke. I had stewed on this decision for weeks. Yes, by the gods, I was wholly ready to do this.
He asked me to get undressed. I asked if he meant everything or just the pants and underwear...he said that was it.. I could leave the top on (thank goodness), just they lower bits.

After doing this G moved her chair to the head of the table and I had climbed up on it. Dr. Barham asked me to place my butt on the metal plate on the table at the foot of it with white lines of goo on it then to place my legs in the stirrups. Now that boys and girls was a new, frightening and yet interesting experience for someone who has never placed their legs on medical table stirrups. I tried to ease back. My butt slid on the metal plate that was covered with it's white conductive jelly goo.

I was scrubed thoroughly with more Betadine. They didn't need to shave as I had done a great job of shaving that area that morning. Doc reach out and took my scrotum in his hand and started to feel out the cord of my right teste and found a point high up... above the top edge of the scrotum and but still able to feel the cord. There he made a couple injections deep into tissues and into the cord and injected Lidocaine. The injection, to my surprise, didn't hurt. There was a tiny prick but that was it. It hurt I tiny bit, but not even enough to say "ouch". I never really noticed my testes getting numbed. He repeated the procedure on the left side. Next he told me he was going to inject the scrotum where the incision would be. I had heard in previous accounts that this hurt the most. For me, however, it was no more or less discomforting than the cord injections. I had expected much worse. I had Georgiana's hand as he began the incision to remove my "manhood". After the initial scrotal incision he used the cautery tool to cut and cauterize through the tissues that held the teste inside the end of the course, a thin, yet strong fibrous tissue and muscle on the distal end of the teste.

I heard accounts from other people who had orchies saying the room stank of burning flesh, however, I could really only smell a faint odor from the cautery and I would not have called it burnt flesh or any such thing. Organic yes, but not vile.

As I realized that I couldn't really feel a damn thing, I just had to sit up and watch what he was doing. I was surprised to see the cord and all was as thick as it was. From what I could feel all my life through my own scrotum the cord didn't seem so large and thick. As I had read the book ,Urologic Surgery, the night before I asked Doc a few questions about what he was doing like "Are you doing to suture the primary teste artery to the ligament so you don't end up with advanced arterial retraction that could lead to hematoma post op?" He said that he would. Turns out he was using 2-0 SAS instead of the 3-0 SAS suture I had anticipated. Personal choice I suppose, I would have gone with 3-0 I think.. but then I wasn't looking at the cord at the time so tissue friability would matter.

The doc finally had to ask me to lay down as I kept myself propped up on my elbows trying to see what he was doing. Years studying and working in medicine will do that too you. I have such a deep scientific curiosity. I was propped up so much and so fascinated that I hardly held G's hand during the procedure.

The same removal and cautery process was used on the left side. This time as he was about to ligate and cut the cord I could actually feel the cord being pulled on deep with in my lower abdomen. The tugging could be felt someplace deep in the center and toward the back. It was not painful, but not a wholly comfortable experience either. Nothing to be scared of that is for sure.

Before I knew it the last teste was removed.

This experience ended up being more like a science field trip than the deeply emotional process and surgical amputation I had expected. I was more curious than anxious, scared or in pain.

Dr. Barham made subcu SAS sutures which was really nice. It means it will not be necessary to return to have the suture removed. Also they tend to hold better, cause less scaring and are less likely to get infected. They take a little more time to do than regular mattress sutures and tiny bit more patience and skill but are the best in the long run. I was pleased to see him use that suture.

Dr. Barham had placed both testes into a small glass container that looked very much like a shot glass on would take tequila shots with. When he had finished the procedure I asked him if he could put "those" in 10% formalin for me to take home. I thought that was a long shot request... but he was like "Sure" and the nurse got a specimen jar for me and he placed them in there. Pics

Dr. Barham wiped up the mess on me that had been made and placed some cotton on my incision line. I stood up, took a paper towel from the Dr. and wiped the conductive goo from my buttocks and put my panties and pants back on. I was surprisingly pain free immediately after the procedure. I could no more tell if I had testes or not.

When we left to pay the receptionist she asked if I could would like a brown bag for "them". I told her I would very much like a brown bag. The idea of walking around with my testes in a clear jar visible to the public is simply really bad form. We left and walked down the hall remarking that I was in fact, in reality, was this very moment, holding my own testicles in my right hand. I was really tripping on that concept.

We drove from the Dr.'s office my work to print off some invoices. I was surprisingly mobile still but starting to feel pain. Then we drove to the pharmacy to get my meds. But his time.. some 40 minutes later I was really quite needing my pain medication. I went in with Georgiana thinking that they may want to verify who I am before giving out the script and I didn't want any delay caused simply because I sat in the car and didn't come in.

The woman was quite prompt as I think she could read the expression of pain on my face.  I took a pill as soon as I could.

We drove home and I immediately hit the sack to lay down. I stayed that way until late the next day. I got up to pee a couple times and found that pushing when I had to go number two only caused greater pain than before. So potty had to come slowly and naturally.

48 hours post op:

Up, mobile and feeling little pain, only mild discomfort. Minor swelling.

72 hours post op:

Decided to be active and ran around town shopping.. got sore.

96 hours post op:

Less active. Had to take a pain pill and get off my feet.

120 hours post op:

Quiet day, wore too tight of pants all day, was at work. Mild soreness. Walking fine. Occasional momentary instances of pain that come quickly and leave just as fast.

142 hours post op:

Noticed a throbbing bulge appear in my right teste blank spot. Feels like the artery end inside the sutured cord has blood some and the closed cord has swollen a little. Reducing activity, wearing lose clothing, no aspirin, only Ibuprofen. Seems ok by night.. Swollen  but stable, mild throb once periodically.

11 days post op:

Majority of swelling is gone. Only minor soreness when pressure is applied directly to the area of the cord. No further swelling. Very active and can wear almost all my clothes. The firmness of the remaining swelling prevents good tucking of the penis back:

14 days post op:

No sensations of pain. Only soreness when pressing on the area of removal. Incision is mostly healed. Tiny bit of suture where it was tied is visible and should fall away in about another week. Occasional itching due to the suture and the body breaking it down. Feeling great overall. Glad to be off the anti-androgen pill.

Emotional state:

All in all feeling wonderful that I had it done. They are gone. I fell them gone. I can feel the absence of T in my body. No more Spiro than the gods. Wonderful procedure. I should have been less active for one week.. my fault for the later swelling. Highly recommend procedure for suitable candidates. I expected to have a decrease in sex drive but have experienced none. In fact feeling more sexual now. Having had the procedure has taken a lot off my mind and feel freed to think about other things. I can still be become erect when stimulated and that discovery surprised me. It’s interesting to see that sexual function and sex drive are not both uniformly controlled by the amount of testosterone in the body. In just one week I have seen a slight increase in breast fullness and overall size. I’m 110% pleased about having the orchiectomy.

Cost $750.00 Total. Procedure time under 1 hour. Recovery really, one week for 60% reliable ability, mobile but not with great exertion, i.e.... no running, lifting, etc.

Robyn Browning
 
Addendum: August 16, 2001

I am still not able to tuck things out of the way due to the swelling that remains in the sac at the in end of the cord. All my pants and slacks fit snuggly in the groin and not being able to tuck is really limiting my options. I have only minor pain now... and it is brief. The middle and lower back part of the scrotum hangs down in a funny fasion. More accurately it hangs in an empty fassion. A word of advice is to STAY INACTIVE for at least a week after the procedure. I a small hematoma internally due to the fact that I was feeling better after a few days and got up and was doing all kinds of stuff. DON'T. I'm lucky my sac didn't fill up like a purple orange. I feel great though. Sex drive is still intact.. adjusting to high dose spiro long term really helped me I think. I can even get erect manual and orgasm. That was a big surprise that I could still do that. Though there is zero fluid coming out. I expect over time even manual stimulation will fail.

Addendum: October 21, 2001

That tucking issue has long be put behind me. As the internal swelling has gone and the scrotum has contracted I can now *cough* put things away much easier. Jeans fit better and there doesn't seem to be much to hide. I'm so please to have had it done. Interestingly, my sex drive has dramatically increased after stopping anti-androgen therapy and having the orchiectomy.