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Elective bilateral orchiectomy (MTF), the removal of both testicles, is done through an incision in the scrotum. After each testicle is pulled from the scrotum, its spermatic cord is clamped, double sutured to control bleeding, and cut, releasing the testicle. The end of the cord is then placed back in the body. The procedure is done on an outpatient basis under local or general anesthetic, depending on the patient.