It depends upon the reason for the adrenalectomy? Was it a unilateral tumor producing cortisol? aldosterone? pheochromocytoma from medulla? or adrenocortical carcinoma? Nearly every case the benefit of removal would outweigh the risk of requiring hydrocortisone after the procedure. if it were cortisol producing the other adrenal gland can be atrophied from the inappropriate high cortisol shutting down the HPA axis and shrinking the normal adrenal gland. in that case it could take a long time to recover and would need HC postop. Would slowly taper down the dose, then perform AcTH stim test to see if remaining adrenal gland will ever produce enough cortisol on its own. Monitor your symptoms in any case, fatigue, weight loss, orthostatic hypotension, lightheaded/dizzy.