I opted for bilateral orchietomy as soon as I was told that I would need ADT for at least 3 years. When looking into it my decision was based on: 1 I did not want more kids, as at 53 I see having kids is irresponsible. 2. After a prostatectomy I am sterile anyway. 3. Even if I can come off ADT it can take months to years for testicular function to recover, if at all. 4. The ADT drugs increase the risk of diabetes and heart conditions beyond the effect of castration. It took some time to convince my surgeon to perform the operation but he said faced with such logic I was correct.