An orchiectomy is a procedure which removes the testicles. As the testicles are the main source of testosterone, you will likely no longer need anti-androgen medications after surgery. It is important to work with your hormone provider after surgery to ensure your medications are adjusted adequately.
During an orchiectomy, both testicles are removed and the spermatic cord is cut and allowed to retract into the groin. This is all done through a midline scrotal incision. The testicles are then sent for analysis by the pathology department to check for any abnormalities
A scrotectomy removes the scrotal skin, creating a smooth area of skin where the scrotum once was. This can be done at the same time as an orchiectomy if you desire, but is not a required part of an orchiectomy. If you do not have a scrotectomy at the time of your orchiectomy, then you will have an empty scrotal sack. This remaining scrotal skin can be important if you want to pursue a vaginoplasty later on.
When a scrotectomy is performed, the scrotal skin is completely removed. There may be a small amount of skin left around the base of the penis in order to prevent tethering, especially with erections. A scrotectomy is irreversible.