Irradiation of the scrotum: what some men need MOST: the Manual Orchid Shielding Technique

Although the need for radiotherapy to the scrotum is now unusual, shielding for the contralateral testis is used to maintain fertility and to preserve the endocrine function of the testis. We report a simple radiotherapy technique to achieve this by manually removing the contralateral testis proximally from the scrotum, to the level of the inguinal ring, where it is held by the patient during radiotherapy. A lead shield placed over the hand, testis and penis reduces the dose to the testis to an acceptable < 1.5% of the tumour dose. This can be confirmed by thermoluminescent dosimetry.