SRS as a medical option?

Ok.... This is Wacky.... (surprise!!).... but my boss just had prostate surgery and it didn't go well... may have spread out of the prostate but don't know yet. Plus my dad died from prostate cancer that spread into his bones as did my assistant's father... I was chatting with another coworker who had his removed last year and after listening to what he went through I blurted out.... "If I'm going to get prostate cancer then I might as well get a sex change and get it cut out right now" !! He thought that was funny....

But it got me to thinking... If you have a genetic propensity for prostate and or testicular cancer then could or should a gender change be prescribed to save your life?? Would you do it or not?

There can be some nasty side effects to having the prostrate removed, including both rectal and urinary incontinence, erectile dysfunction, and there are others. Of course in the case of SRS, erectile dysfunction isn’t much of an issue. If it wasn’t for the side effects I think many Doctor’s would recommend having the prostrate removed before it could become a problem.

SRS wouldn't have any affect on the prostate, in an of itself. The antiandrogens and other hormones may, however, depending on whether it is an enlargement issue or the type of cancer it is susceptible to.

My granddad died from an enlarged prostate, no cancer, just because he didn't do have it looked at.

They might prescribe removal of the trouble-prone bits, but SRS is a lot more complicated than that.

*knowing that Karren is joking*

The prostate is not removed during SRS surgery in 99.9% of the cases. As noted this would be likely to lead to incontinence. From Marci Bowers

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(MTF) Does Dr. Bowers remove the prostate?

If this is not a normal procedure what are the reasons for leaving the prostate in?

The prostate shrinks so remarkably on Estrogen that, in my opinion, it does not deserve worry after surgery. I do recommend one PSA (Prostate Specific Antigen) performed one year after surgery. During surgery, we go THROUGH the prostate but do not and cannot remove it. There are many recommendations for post-ops to have their prostates examined (just as some recommend pap smears for MTF's). I believe, both recommendations are odd/alarmist and do not fully account for the physiology of the cancers they are trying to detect. So long as a post-op remains on estrogen, there is very little worry about prostate cancer. If the prostate does need examined, it lies in front of the vagina. Therefore, it should be issued vaginally, not rectally.

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Karren, are you serious? If it was me I would be aiming this question at a qualified doctor not us lot. [apart from the qualified doctors here]
Do you have a genetic propensity for these sorts of cancers?
Go to your doctor and let him put your mind to rest.

Since my father had it then I watch my PSA religiousl.... It runs in familys. And I can't believe they don't take the prostate out during srs! Especially given its location!! Seems like it would be directly in the way!! Lol.

This brings to mind a fantasy I used to have when I was much younger. It went something like 'You have a rare medical condition which can only be controlled by putting you on massive dosages of estrogen. Side effects will be feminization and large breasts, but it is the only way to control the condition".

Shortly into the 'treatment', my mom would realize that we needed to go bra shopping.

Of course, in my fantasy this always lead to my parents to conclude that I looked more like a girl than a boy after a few months of therapy and none of my boy clothes fit anymore. To so to cut back and any potential bullying when I returned to school after Summer vacation it would be easier to just put me in a dress and register me in a new school as a girl... but to keep anybody from guessing I was a boy, I'd need to wear dresses and frilly stuff all of the time.

This lead to shopping trips, a closet full of skirts and dresses, throwing all of my pants and shorts into the dumpster, etc... sigh. I actually used to pray for something like this to happen.

Karren, they probably do not take it out during GRS because of the potential for side effects primarily urinary incontinence. Unfortunately, that little walnut sized organ is encapsulated with a very important nerve bundle that controls continence and erections. As said above that while erections are not of interest to the GRS patient, the continence is very important. Speaking from personal experience, wearing pads for 16 hours a day with all of the other bothersome effects of that is a royal pain in the butt. However, removing the testicles, the source of most of our testosterone and the later driver for the cancer, might not be a bad idea for someone with a strong hereditary propensity for prostate cancer.

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Originally Posted by Karren Hutton

Ok.... This is Wacky....
But it got me to thinking... If you have a genetic propensity .... should a gender change be prescribed to save your life?? Would you do it or not?

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Just taking the parts of the statement and making a question?

Answer:

While, I'm still considering the idea of SRS at some time in the next 3 yrs. (doing what I need to at this time for possible prep) I have the opinion just now of, not actually "finishing" my transition (read SRS) but if my Dr. said something to the effect of "removal is required" I don't think I'd look for a second opinion, but agree quickly.

I guess I'm saying that if the responsibility is taken by somebody else and I don't have to make the decision then it's OK with me

So, if removing the testosterone source is a positive move toward the prevention of prostate cancer, then the answer to Karren's question is....YES.

I've wondered the same thing but in regards to testicular cancer. Nature has built in redundancy in that area so SRS probably wouldn't come into decision making unless a total castration was in order. I've often thought that I might as well go for SRS in that case. All hypothetical now since testicular cancer is generally a younger persons problem.

As has been mentioned, the prostate stays in place almost always after SRS. It is in fact a desired organ to keep, as it does have something to do with sexual gratification after SRS ( think of it as your new Gspot). The testicles are removed. If testicular cancer was a major risk for you, then SRS would seem to solve that problem. More than a bit radical ... but it would work ;)

Although not that common, ERT or Estrogen replacement therapy, is used to treat prostate troubles. That's going to shut down the prostate. Dutasteride is made for this function, but without many of the {normally} undesired effects of estrogen. Considering your family history, I would not be surprised if your doc prescribed it for you sometime. Please excuse my too-personal question, but are your PSA's drifting upward ?

I would give it serious consideration.

I had prostate cancer (now cured fortunately) and received radiation as well as hormonal therapy. Had hot flashes, some breast enlargement.

The good news is prostate cancer, if caught early, is very curable. The bad news is the PSA test is very unreliable as an indicator.

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Originally Posted by Karren Hutton

And I can't believe they don't take the prostate out during srs! Especially given its location!! Seems like it would be directly in the way!! Lol.

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but then you would lose you G-spot

I have read on the internet that removal of the testes is a viable way of dealing with prostate cancer. It removes most of the problem testerone and the doctors give low doses of T replacement drugs. Sounds extreme, but it seems to cause the cancer to go into a type of remission. Lets face it which is easier, cutting a sack and cutting out two balls, or going internally. Most men are horrified at the thought of losing the family jewels. If it were me, bye bye jewels. I have already lost to many family members to cancer, thank you!

My grandfather recently had a procedure called a perineal prostatectomy. The reason this procedure was opted for was because as with most cancers, it needed to be known if the disease had spread to surrounding lymphnodes. Thus, biopsies and margins were taken from the surrounding areas. Luckily, he is now cancer free. Having said this, he does now have to wear an adult diaper and it has severely affected his personality and self-esteem. He isn't the same person really anymore and I am hoping that he recovers and realizes he made the right decision for his life. As it is, the procedure is obviously very invasive and nerve tissues were damaged during the operation. Because of this, he will no longer be able to achieve erection. From what I understand about SRS, they try to keep most of your nerve endings intact (herp derp) so that you can enjoy sexual stimulation. Of course, things happen in such sensitive regions and damage may very well occur to those nerve bundles. So, if you are thinking about getting a SRS and a prostatectomy and shrugging off the no erection side effect of the prostatectomy, realize that things can go very wrong in both surgeries to cause no sensation to those areas. Overall, my grandfather was under anesthesia for 6 hours and this is considered a dangerous zone, especially for his age. I was furious because 4 hours was the estimate surgical time...so, it's usually going to last longer. Overall, he was under the knife for 6 hours and I was hopping mad...had a pep talk with the anesthesiologist and CRNA before the surgery. I do not think that it would be advisable to undergo a prostatectomy AND a SRS in the same surgery if that is what you are alluding to. The recovery time for a prostatectomy is around 6 weeks, but that varies with age. It has been over 6 weeks and my grandfather is still in pain. So, you would have two procedures and considerable down time from both. But, people die under the knife every day...anesthesia is a scary thing and just because you make it out of the hospital does not mean that you are still safe. My mother (who is an RN) moved in with my grandfather for a week to help him because he could not physically help himself. This is a man who was crawling under my car a week prior, building me a gate, was always outside working on something, and generally had more energy than myself...and, is now down for the count because of this surgery. He will be fine eventually, but it's very strange and he's not the type of man that wants to be cared for. So, imagining both surgeries just sounds like insanity.

If it still sounds like a good idea to undergo two surgeries, go for it. I'm glad my grandfather got the prostate removal because it saved his life. However, that surgery in and of itself has changed his life in such a dramatic way that it baffles me to think of having to transition simultaneously.

It's an interesting idea. I'm not sure any medic would advocate precautionary removal of a healthy prostate (compared to some women who have healthy breasts removed, but that's because they have some genes that give a very high incidence of breast cancer), probably because of the incontinence affects. They do use androgen blockade and drugs to stop production of testosterone which helps as growth of the tumour is often driven by androgens, so removal of the testes would certainly get rid of that. At the place I'm working they are doing a trial of oestrogen patches in treatment of Ca prostate, so it might be possible to push for orchidectomy and HRT, but I think the treatment may be directed by other factors

Medically speaking, the removal of a male prostate is an extremely serious operation. The risks of nerve damage are very high. And the risks of incontinence is very high also. The urethra goes RIGHT through the prostate and so must be cut and reattached during surgery. This is an delicate job. Cutting ANY area so loaded with nerve endings is fraught with danger. As has been already mentioned, incontinence and loss of erection capability are both very common with this operation.

Prostectomy is NOT to be taken lightly. SRS surgeons do NOT remove the prostate during sex reassignment for good reason. It's not necessary and very dangerous.

Stephie

What about a bi-lateral orchiectomy?

A bi-lateral ochiectomy (removal of both testicles, not the scrotum) can be done on an outpatient basis. It's a MUCH simpler and easier operation. Local anesthetic, home right after, work as soon as you can, usually in several days to a week.

You may very well take longer if you wish. You may very well want to take longer. Many surgeons may want you in hospital over night for safety. But it's a MUCH easier operation.

S

seems like i always want to post but the time I get to the last threads I think I want to barf, I mean, orchiectomy. Geez. Just the word will shrink them.


















geez

I had this fantasy too.

Turned out that I did have a rare medical condition, and it turned out I took estrogen and srs to cure it...

What a world

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Originally Posted by Cristi

This brings to mind a fantasy I used to have when I was much younger. It went something like 'You have a rare medical condition which can only be controlled by putting you on massive dosages of estrogen. Side effects will be feminization and large breasts, but it is the only way to control the condition".

Shortly into the 'treatment', my mom would realize that we needed to go bra shopping.

Of course, in my fantasy this always lead to my parents to conclude that I looked more like a girl than a boy after a few months of therapy and none of my boy clothes fit anymore. To so to cut back and any potential bullying when I returned to school after Summer vacation it would be easier to just put me in a dress and register me in a new school as a girl... but to keep anybody from guessing I was a boy, I'd need to wear dresses and frilly stuff all of the time.

This lead to shopping trips, a closet full of skirts and dresses, throwing all of my pants and shorts into the dumpster, etc... sigh. I actually used to pray for something like this to happen.

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Originally Posted by Karren Hutton

Ok.... This is Wacky.... (surprise!!).... but my boss just had prostate surgery and it didn't go well... may have spread out of the prostate but don't know yet. Plus my dad died from prostate cancer that spread into his bones as did my assistant's father... I was chatting with another coworker who had his removed last year and after listening to what he went through I blurted out.... "If I'm going to get prostate cancer then I might as well get a sex change and get it cut out right now" !! He thought that was funny....

But it got me to thinking... If you have a genetic propensity for prostate and or testicular cancer then could or should a gender change be prescribed to save your life?? Would you do it or not?

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Karren, I belive that to halt the spread of prostate cancer, they usually do an orchiectomy first--removal of the testes. My father also died of prostate cancer and had the procedure done but it was too late in the game. also, the PSA test has been discredited and the establishment now recommends the of tried and true method of palpating the prostate via you know where. There is a new proctacologist in your town whose name is Dr Ben Dover.