Phantom sensations after orchiectomy for testicular cancer

Phantom sensations have been frequently reported after limb amputations, but they seemed to be rare events after urological operations. All 81 consecutive male patients (median age 28 years; 16-51), seen during their routine follow-up visit at the oncology outpatient department of Hannover University Medical School between January 1st and June 30th 1991, who had undergone unilateral orchiectomy for malignant germ cell tumors of the testis, were evaluated for the prevalence of testicular phantom sensations. Ten patients (12.3%) reported phantom sensations. One patient with subsequent bilateral orchiectomy developed phantom sensations after each operation. Neither tumor or treatment related factors nor social parameters were closely associated with the occurrence of testicular phantoms. Phantom sensations began within the first weeks after orchiectomy and in 7 of 11 (63.6%) patients the phantom feelings disappeared within 18 months after orchiectomy. Nine of the 11 patients experienced painful phantom sensations. Three patients reported a significant influence of the phantom feelings on their sexual life and one patient was surgically re-evaluated under the suspicion of a second testicular tumor because of persistant phantom pain. In conclusion, the occurrence of phantom sensations after orchiectomy has been neglected in this group of young cancer patients with good prognosis. With respect to treatment related side effects and the quality of life of testicular cancer patients, oncologists, urologists and neurologists should be aware of this phenomenon.