Contemporary practice of testicular prosthesis insertion

Area of Science:

• Urology
• Pediatric Surgery
• Andrology

Background:

• Orchidectomy, the surgical removal of a testis, is performed for various medical reasons including atrophy, undescended testes, torsion, and tumors.
• Testicular prosthesis insertion (TPI) is an option for patients undergoing or who have undergone orchidectomy to restore a more natural appearance.
• Understanding TPI practices in relation to orchidectomy is crucial for optimizing patient care and surgical planning.

Purpose of the Study:

• To evaluate the practice patterns of testicular prosthesis insertion (TPI) following orchidectomy within a specific geographical region.
• To analyze the differences in TPI rates across various age groups of males undergoing orchidectomy.

Main Methods:

• A retrospective analysis of male patients who underwent orchidectomy between 1989 and 2009 was conducted using Scottish Morbidity Records.
• Patients were categorized into six distinct age groups to compare TPI rates.
• The study examined the rate of TPI and its timing relative to the primary orchidectomy procedure across these age groups.

Main Results:

• A total of 3364 orchidectomies were performed over the 20-year study period.
• Out of these, 530 patients (15.8%) received a testicular prosthesis insertion (TPI).
• Postpubertal males demonstrated a significantly higher likelihood of receiving a simultaneous TPI at the time of orchidectomy compared to prepubertal males (83% vs. 32%; OR 10.44, P < 0.01).

Conclusions:

• The findings suggest that younger males are more prone to receiving a testicular prosthesis insertion at a later stage post-orchidectomy.
• Paediatric urologists should consider the potential for concurrent TPI during initial scrotal or groin exploration in pediatric patients.
• This proactive approach may improve patient satisfaction and reduce the need for secondary procedures.