Just to note that as with any surgery, there is an element of risk and that in this case the risk is obviously damage to the testes and the way they function, or trauma and damage to the  nerves and capilliaries that supply the testes with nutrient and hormone which could mean reduced function of the testes at the end of the day which is not what we want to occur.  Mostly surgery to my mind is a very crude way of dealing with the problem.    

From my understanding of tumors or even cysts on ovaries for that matter, they tend to regress when the hormone imblance is addressed.  In other words in this instance the tumors are caused by over production of male hormones ansd estrogen, but correcting the hormone imblance with a higher dose of cortisol and taking bloods regularly (three monthly) could lead to correction of the problem all by itself.   The patients Doctor needs to concentrate more on prevention than the bandaid approach or quick fix approach after the fact.   Especially if the patient has had CAH since birth.   Possibly boys diagnosed later may have had more exposure before a Doctors intervention and in that case, such boys will need adequate treatment to get tumor growth under conrol and make the tumors regress.   It’s a little similar to the women whom have PCOS.  There is little sense removing cysts from ovaries that are malfunctioning because the patients hormones are out of whack, because when you do remove cysts you risk trauma and damage to the ovary itself, and doing so,  Ovaries being like testes are very delicate organs and when mishandled during surgery, adhesions can form when they cut away the cysts.  Adhesions generally form after surgery due to the trauma of the surgery itself.  Inflammation, lack of movement after the operation itself, inadequate diet, infection following surgery.  Fibrin and adhesions start to form within hours after surgery infact.   People with blood type O may be less susceptible to adhesion formation than others simply because their blood flows more quickly though the veins and they are less susceptible to haematoma’s or blood clotting than a type A for example.   Any fibrinogen in the blood is moving quickly though and less they are less likely to have enough fibrin available to the tissue for formation of adhesion.  They have good circulation to their wounds and organs or tissues. 

Having done a lot of study into adhesions and fibrinogen I know that there are supplements that you can take to reduce inflammation, infection and which also inhibit fibrinogen in the blood, but the risks for damage in the surgery are still there despite taking such supplements.  Bromelain from pineapple and the protease enzyme that it contains for example is something that when in highe enough doses after surgery, can improve circulation, reduce inflammation and also inhibit fibrinogens.  Hence anyone taking such can improve the outcome of their surgery significantly.  However, it doesnt remove the risk of trauma to the organs itself or damage created when the tumors are removed or the cysts fro  ovaries.  

 

Actually, bromelain eats dead tissue in the body. I.e. tissues formed by fibrin, fat, plaque in arteries.  There is a treatment now know as Chelation and if you look that up it will give you a number of things that that treatment can help with.  Personally if it were me I would make sure my treatment with cortisol was stepped up for a while to regess the tumor, and then make sure the male hormones are held at consistent levels so that tumor growth cannot be fed.  More than lijkely that means taking aromatase inhitors to block estrogen production but one of the best aromatase inhibotors would be soy protein powder.   Taking about 50 grams of that a day would inhibit production of aromatase to a certain extent.  Taking something like bromelain may even reduce tumors further to my mind.  I’d certainly try the obvious treatments and the natural ones before bowling into surgery which is a radical last step IMO. 

For example, an ovary which forms an adhesion to the abdominal wall or another organ will cause problems or the ovary can malfunction.  After something like a tubal ligation if an adhesion forms and malfunction occurs in the ovary then you can get cysts forming on the ovary due to hormone malfunction from te ovary itself.    If that adhesion canot be fixed or repaired after one or two surgeries, their next line of approach is to remove the ovary completely, as anovulation causes problems with menstruation and dependant upon your quality of life or symptoms WITH the ovary, they may feel it is best to remove it.  In the case of a testicle it is almost as big a deal as a womans ovary being removed.     Removal of ovaries means an earlier menopause for women and LESS hormones produced from such after menopause which leads to bone loss.  Well the same occurs for men whose testicles are damaged in surgery or removed. 

This is why I think it is very important to consider things before such ANY type of surgery, because should such damage occur, or testes malfunction later or not function as they should, it can create fertility problems anyway--which rather detracts from the reason that you had such operation in the first place.      When the problem causing the tumors is dealt with, the tumor growth should halt as it is generally excess estrogen that feeds the tumor growth.  So theoretically removing the estrogen out of the equasion and reducing the male hormones to a better "normal" level should see the tumors regression.    Even if tumors does NOT shrink back or regress completely, as long as they give the correct doses of meds and the  ratio of cortisol is correct to the ratio of 17 OHP or other androgens, then technically, the tumor will not advance and will remain controlled.  This sometimes happens with brain tumors.  They dont bowl in right away and remove said tumor.  They do scans and monitor the tumor as sometimes tumors can be quite harmless if they are controlled with hormone therapy which treatment fo CAH is basically. 

I think it is something you really need to think about.  I don’t think I have seen ANY study where they examined the regression of such tumors or really worked at keeping the hormones as they should be after tumor diagnosis in order to help such tumors regress in CAH men.  Which means, basically that operation to remove such could be quite premature and even risk damage that far exceeds what tumors kept under control would cause.