Sparing a testis during vaginoplasty in male-to-female transsexuals: Does it benefit our patients?

Testosterone and its metabolite dihydrotestosterone are the libido hormones for the male, vital to sex drive and sexual function. Fear of loss of libi do and orgasm is the main reason to retain at least one testis in male-to-f emale transsexuals during vaginoplasty. We report on four South American tr anssexual patients in whom we resected a remaining testis to illustrate the superfluity of retaining it. Because there are multiple reasons for castra tion, we advise that bilateral orchidectomy be performed in the course of s ex reassignment surgery for male-to-female transsexuals.