Has anyone had to have both testicles removed?

@mordy, I can imagine that this surgery has you concerned about your sexuality. I'm tagging other members who have experience with orchiectomy to remove one or both testicles like @rxharleydude @05271935 @hwkaiser @ozzie51 @janar.

Mordy, has your surgeon talked to you about implants and testosterone replacement therapy?

Thanks for responding. To answer your question not yet. I'm meeting with my surgeon to talk about the surgery in a week.

I know I was told not to have implants since I've had scrotal issues. I'm ok with not having artificial testicles.

I'm glad to see this subject come up as I'm facing an orchiectomy to remove my right testicle in a few weeks. I had two groin surgeries last year and the second one left me with a dead right testicle. First surgery was for the repair of a rather large hernia in the right inguinal area and since scans were also showing a smaller hernia on the left which was a recurrence of one I had repaired 40 yrs before, I had bilateral hernia repairs . Those repairs were done laparoscopically and mesh was added across my whole lower abdomen. During recovery both testicles had significant swelling which I iced frequently; no real pain just discomfort from being so large.

A few months later, after everything had gone down, I could feel a "growth" on my upper spermatic cord (not that I knew what that was at the time). Surgeon thought it was just a pocket of fluid that would dissipate. When it didn't, he ordered a CT scan and the results indicated another hernia (both the surgeon and I doubted it); so an ultrasound was done and results were the same - most likely a hernia. So I was scheduled for another hernia surgery which had be done with open cut; no hernia found but there was a fatty growth on my spermatic cord exactly where I had felt it and another was found lower down closer to the scrotum. Both were removed and biopsied and thankfully not cancerous. I have since learned that type of fatty growth is called a lipoma and is harmless and could have been left in place with no repercussions - I had pushed to find out what it was so I can't fault anyone. Following the last surgery, only the right testicle swelled and it really swelled up; was not painful but uncomfortable. It was very very large and grainy feeling; I was disappointed that no one seemed concerned about it (especially my now, former urologist). Swelling went down but not the strange grainy feeling of the testicle.

In just a few weeks, I started having hot flashes and was totally rundown by mid afternoon. Didn't take a genius to figure out that my testosterone was low; my primary care doctor ordered a blood test which confirmed it was extremely low. Then another ultrasound was done and I was informed my right testicle was "dead" and would not come back. Finally referred to a urologist who specialized in men's fertility issues (not that in my late 70s I am concerned about fertility per se). She got me on testosterone replacement treatment and the improvement was almost instantaneous; she said it would be best to remove the testicle which could become gangrenous. I was going for 2nd/3rd opinions; whether it would be a gangrene infection or another kind, leaving it in seemed not to be a good idea.

I have asked for a prosthetic testicle but heck if I know what I'm getting - I'm concerned about the size and feel. I'd love to hear if anyone has had this done and what they feel (pun not intended) about the implant. The dead testicle is a hard knot but it gets larger during the day and goes down during the night - it feels strange. It was always the larger of the two; the smaller one is getting smaller because it doesn't have to work since I'm doing TRT. I suggested taking both out but that didn't not get far with my new urology surgeon! Sorry for making this such a long response but I do say the testosterone treatment has been wonderful; I feel better in many ways including more energy, better libido, and even getting some fuzz on my bald head!

I had 9 scrotal surgeries as one of my Urologist reminded me last week. I've been having issues for the past 9 years.

Testicles have 2 jobs: make sperm, make testosterone
They also of course occupy and create the "normal" visual appearance of the scrotum

Anyone with bilateral Testicular removal will require lifelong Testosterone replacement to achieve normal physiologic T levels for a man (women create T from other sources including adrenals) - this is straightforward and safe and nowadays can be done with bimonthly injections, daily pills or a procedure about 4/year.

People still wanting to have biological children would need to freeze sperm ahead of testicle removal.

Men who undergo orchiectomy (removal of testicle) may choose to use testicular prostheses at the time of testis removal. This is a personal choice and many men are fine without the implants whilst others feel much more comfortable & self-confident with this safe and effective procedure. Either way is fine - a Urologist would do this surgery and they and or primary care/endocrine/IM could help with the T replacement strategies.

Dr Kohler
Professor of Urology
Head of Mayo Men's Health Rochester MN

Thank you for responding and giving me a better understanding of what I'm going to have to go through. You mentioned an option of a precegure every 4 years. What type of precegure and is that better than having to have injections every so often ?