Suprascrotal Approach for Testicular Prosthesis Placement in Children after Testicular Torsion

Testicular prosthesis placement enhances body image and satisfaction in pediatric patients after orchiectomy due to testicular torsion. However, no standardized guidelines exist for the optimal surgical approach with minimal complications. Our aim is to describe a simple and reliable technique of testicular prostheses in pediatric patients, avoiding the inguinal approach.

A retrospective multicenter study was conducted on patients under 18 years who underwent prosthesis placement following orchiectomy for testicular torsion between 2016 and 2022 in four hospitals. Prostheses were inserted through a supracrescrotal incision at the penile base, creating a subcutaneous pocket via blunt dissection towards the scrotum. No drains were placed.

A total of 21 patients were included (median age of 14.9 years; interquartile range (IQR) 13.4-15.8 years) with a median time between torsion and prosthesis placement of 14 months (IQR 10-17 months). Regarding the size, 14 prostheses of size 42 × 32 mm and 7 of 37 × 28 mm were placed. Median operative duration was 15 minutes (IQR 12-18 minutes), with no intraoperative complications. All patients were discharged the same day of surgery. After a median follow-up of 41 months (IQR 26-54), no infections, prosthesis extrusions, or complications were reported. Patients experienced no pain or discomfort, and all reported satisfactory outcomes. No prosthesis exchanges were required.

Suprascrotal testicular prosthesis placement appears to be a straightforward and safe procedure for adolescents after testicular torsion, providing excellent cosmetic and satisfaction outcomes with low morbidity in the medium term. Larger prospective studies are needed to confirm these findings.