Initial Results for Combined Orchiectomy and Prosthesis Exchange for Unsalvageable Testicular Torsion in Adolescents: Description of Intravaginal Prosthesis Placement at Orchiectomy

Bush, Nicol; Bagrodia, Aditya

doi:10.1016/j.juro.2012.02.030

Cited by 22 publications

(12 citation statements)

References 15 publications

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“…Alternatively, Bush and colleagues describe a technique of placing a testicular prostheses intravaginally at the time of orchiectomy in patients with unsalvageable testes secondary to testicular torsion ( 69 ). Although reported with a relatively small cohort (n=12), there were no infectious complications or extrusions at a 5-month median follow up.…”

Section: Testicular Prostheticsmentioning

confidence: 99%

Scrotal reconstruction and testicular prosthetics

Lucas

Lester

Chen

et al. 2017

Transl. Androl. Urol.

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Scrotal surgery encompasses a wide-variety of surgical techniques for an even wider variety of indications. In this manuscript, we review our indications, techniques, and pit-falls for various reconstructive scrotal surgeries as-well-as surgical tips for placement of testicular prostheses. Penoscrotal webbing (PSW) is an abnormal, often-problematic distal insertion of scrotal skin onto the ventral penile shaft. There are several effective and straightforward techniques used to revise this condition, which include simple scrotoplasty, single- or double-Z-plasty, or the VY-flap scrotoplasty. Reconstruction is also commonly indicated following scrotal skin loss caused by infection, trauma, lymphedema, hidradenitis, and cancer. Although initial management of these conditions often involves scrotal skin removal, repair of expansive scrotal skin loss can be technically difficult and can be accomplished by using one of several skin flaps or skin grafting. Split-thickness skin grafting of scrotal defects can be accomplished easily, and provides durable results.

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Section: Testicular Prostheticsmentioning

confidence: 99%

Scrotal reconstruction and testicular prosthetics

Lucas

Lester

Chen

et al. 2017

Transl. Androl. Urol.

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“…[5] Kogan and Bush et al advised intravenous antibiotic perioperatively and then orally for 3–5 days. [5,8] Our technique was similar. However, we chose the size of a prosthesis based on ultrasound measurements of the contralateral testis and additionally distended scrotal sac with a balloon of Foley's catheter, which also acts as a hemostatic.…”

Section: Discussionmentioning

confidence: 91%

“…The most common indications for implantation of prostheses are anomalies of testicular development (agenesis and hypoplasia), [7,9,12–15,17,19] followed by spermatic cord torsion and testicular atrophy after orchiopexy. [7,8,15] Injury and neoplastic disease are infrequent indications for the implantation of testicular prostheses. [15,18,20] Our data are in line with the above-cited findings.…”

Section: Discussionmentioning

confidence: 99%

“…[5] According to Bush et al trans-raphe scrotal access is useful during combined orchiectomy (due to torsion and necrosis of a testis) with implantation of a prosthesis and contralateral prophylactic orchiopexy. [8] We chose mainly inguinal access because many of the boys had been initially operated with inguinal incision. Rarely, we used supra-scrotal or transverse scrotal access.…”

Section: Discussionmentioning

confidence: 99%

“…Kogan, Bush et al, Rose et al, Martínez et al, and Elder et al have emphasized the necessity to exchange prostheses in adolescence. [5,8,9,11,13] We exchanged prostheses once in 108 patients and twice in 37 patients. Therefore, in total, we performed 435 testicular implants in 290 boys.…”

Section: Discussionmentioning

confidence: 99%

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The use of testicular prostheses in boys

Osemlak¹,

Jędrzejewski

Cielecki³

et al. 2018

Medicine

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Lack of the testis is an important factor in psycho-sexual development of the boys, and implantation of the prosthesis plays a very essential role in the treatment of that group of patients. Currently there are no standards regarding when prosthesis should be implanted, and which access is connected with minimal rates of complications. We present our experience of primary prosthesis implantations in boys treated in our department.From 2000 to 2014, primary implantation of the testicular prosthesis was performed in 290 boys. The early and late post-operative complications and long-term therapeutic results were analyzed, considering age at the time of implantation, the time between the initial operation and implantation of the prosthesis, and the surgical approach.Best results were observed in 267 patients and bad outcome in 23 patients. Prosthesis implantation in young boys operated within the first three years of life or during the first year after primary surgery was connected with statistically fewer complications (P = .002 and P < .05, respectively). Supra-scrotal access was connected with the lowest rate of complications (P = .01).Long-term therapeutic results in boys with testicular prostheses were good in the majority of cases. Implantation of the first prosthesis should be performed early between 1 and 3 years of life in boys with lack of the testis. Implantation of a prosthesis should also be performed within 1 year after removing of testis or during orchiectomy. Supra-scrotal access should be chosen for testicular prosthesis implantation due to the best long-term results.

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