Outcomes of Orchiectomy for Gender-affirming Surgery: A National Surgical Quality Improvement Program Study

Abstract

To identify perioperative outcomes of transgender orchiectomy (TGO) and to broadly compare outcomes of TGO to cisgender orchiectomy (CGO) for non-oncologic indications. Using the National Surgical Quality Improvement Program (NSQIP) database from 2010-2020, a retrospective study was performed on patients with ICD-9/10 codes for gender dysphoria, testicular torsion, and testicular pain who underwent simple orchiectomy. Demographics and surgical outcomes were summarized. Welch two sample t-test and Chi-square test were used for group analysis. A trend analysis was performed for temporal trends of these surgeries. 246 patients underwent TGO and 997 patients underwent CGO (607 testicular torsion, 390 testicular pain). Overall complication rates between TGO and CGO did not differ for testicular torsion (3.7% vs 4.4%, p=0.6) or testicular pain (3.7% vs 5.9%, p=0.2). No differences in patient characteristics were seen within the TGO group when comparing those who experienced complications to those who didn't. From 2015 to 2020, TGO cases significantly increased by, on average, 9.5 cases per year (95% CI: 6.3-12.7, p=0.001), while CGO had showed no significant temporal change. Standalone TGO can be performed safely in an outpatient setting with an acceptable complication profile in medically diverse patients.