With no adrenals at all you have no leeway when a problem strikes. Adrenal crisis is rapid. Even with SWCAH some may have a half % enzyme function and this gives a tiny bit of reserve - not for long though! So in terms of adrenal crisis it is more equivalent to having the most severe form of CAH (0% enzyme function) where cortisol production is severely limited.
Basically the ability to conceive seems to improve with no adrenals at all compared to SWCAH. Some studies show that SW and even SV women who couldn't conceive before bilateral adrenalectomy, conceived afterwards.
With an adrenalectomy you may be more likely to need to replace DHEA and /or other androgens.
I can't think of anything else at the moment.
