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An orchiectomy is surgical procedure to remove one or both (bilateral) of the testicles and the full spermatic cords. This procedure is often done prior to GRS as it eliminates most of the bodies testosterone production. There are some variances in how the procedure is performed, depending on the reason it is being done.
For MTF purposes or where cancer is not an issue, an incision is made in the side of the scrotum, the testicle and part of the spermatic cord is extracted. The cord is then clamped in 2 places and cut. The end of the cord is then sutured and allowed to retract. The incision is then sutured closed. The scrotal skin will often retract against the body somewhat. At no point during the procedure is the penis involved. For other purposes, the incision is made above the pubic bone, the testicle pulled through the inguinal canal, the spermatic cord clamped and sutured and then the incision is closed.