The use of testicular prostheses in boys

Osemlak, Paweł; Jędrzejewski, Grzegorz; Cielecki, Czesław; Kalińska-Lipert, Anita; Wieczorek, Paweł; Nachulewicz, Paweł

doi:10.1097/md.0000000000013911

Cited by 6 publications

(4 citation statements)

References 17 publications

(54 reference statements)

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“…Osemlak et al .,[ 7 ] in their study on 290 boys between the age of 4 and 16 years who underwent primary testicular prosthesis implantation, reported outcomes following different surgical accesses such as inguinal, transverse scrotal, suprascrotal, and transseptal scrotal. Early complications such as infection and delayed wound healing were significantly higher about 22% on scrotal access compared to 18% through inguinal access.…”

Section: Discussionmentioning

confidence: 99%

Concurrent placement of the testicular prosthesis in children following orchiectomy/testicular loss

Konamme,

Santhanakrishnan,

Saroja

2023

J Indian Assoc Pediatr Surg

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A BSTRACT Introduction: Testis is essential for male sexual hormone production, fertility, and psychological well-being of a male. In the unfortunate event of testicular loss, placement of a testicular prosthesis perhaps will offer a sense of well-being, improved body image, and overall confidence in the growing child. Aims: The aim is to evaluate the feasibility and assessment of outcomes following concurrent placement of testicular prosthesis in children following orchiectomy. Materials and Methods: This is a cross-sectional study conducted by reviewing the reports of patients who underwent simultaneous insertion testicular prosthesis following orchiectomy for various indications between January 2014 and December 2020 at tertiary hospitals in Bengaluru. Children <18 years were included in this study. A transscrotal approach was preferred in cases where a transscrotal orchiectomy was done. Transinguinal approach was preferred in children undergoing prosthesis insertion as an isolated procedure. The size of the prosthesis was chosen based on the age of the child and the size of the scrotum. Outcomes were assessed on follow-up. Results: A total of 29 children underwent prosthesis insertion (25 unilateral and four bilateral). The mean standard deviation age was 5.58 (3.92) years. The indications for prosthesis insertion were cryptorchidism with atrophic testis (22), torsion (3), Leydig cell tumor (2), and severely virilized Congenital adrenal hyperplasia (CAH) (2). Of these, three children (9%) had complications (wound gaping in two and wound infection in one) that needed removal of the implant. The mean duration of follow-up was 49.23 months. All the parents reported a good outcome, and none of the children who underwent prosthesis placement needed a change during this follow-up. Conclusion: Concurrent placement of a testicular prosthesis is technically easy and a safe procedure, achieves satisfactory cosmetic appearance with minimal morbidity.

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Section: Discussionmentioning

confidence: 99%

Concurrent placement of the testicular prosthesis in children following orchiectomy/testicular loss

Konamme,

Santhanakrishnan,

Saroja

2023

J Indian Assoc Pediatr Surg

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“…Recently, many authors have tried to define the best timing of testicular prosthesis implantation as reconstructive surgery in patients suffering from absence of a testicle (9,18,22,23). In 2012, Bush and Bagrodia (9) reported good initial results of combined orchiectomy and prosthesis exchange in 12 patients treated for testicular torsion with follow-up from 1.5 to 16 months.…”

Section: Discussionmentioning

confidence: 99%

Testicular torsion: a modified surgical technique for immediate intravaginal testicular prosthesis implant

et al. 2021

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Purpose: The aim of this paper is to propose a modified surgical technique for immediate intravaginal prosthesis implantation in patients undergoing orchiectomy due to testicular torsion, and to evaluate the wound healing process and patient’s satisfaction. Material and methods: We prospectively analyzed 137 patients with testicular torsion admitted to our facility between April 2018 and May 2020. Twenty-five patients who underwent orchiectomy were included in this study. Fifteen had a testicular prosthesis implanted at the same time as orchiectomy using a modified intravaginal technique (summary figure) and 10 received implants 6 to 12 months after orchiectomy. Wound healing was evaluated at a minimum of four checkpoints (on days 15, 45, 90 and 180 after surgery). At the end of the study, a questionnaire was administered to measure patients’ satisfaction rate. Student’s t test was used for comparison of quantitative data between negative vs. positive cultures (p <0.05). The chi-square test was used to verify associations between categorical variables and immediate vs. late prosthesis implantation (p <0.05). Results: Patient’s ages ranged from 13 to 23 years (mean 16.44 years). Overall time lapse from symptoms to orchiectomy ranged from 10 hours to 25 days (mean 7.92 days). Only one extrusion occurred and it happened in the late implant group. All wounds were healed in 72%, 88%, 95.8% and 100% of the cases on the 15th, 45th, 90th and 180th days after implant, respectively. At the end of the study, all patients stated they would recommend it to a friend or relative. The only patient that had prothesis extrusion asked to have it implanted again. Conclusion: There was no prosthesis extrusion using the modified intravaginal surgical technique for immediate testicular prosthesis implantation, which proved to be an easily performed and safe procedure that can avoid further reconstructive surgery in patients whose testicle was removed due to testicular torsion.

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“…В структуре осложнений отмечены: воспалительные -48 %, экструзия импланта -24 %, нарушения гемостаза -16 %, сморщивание импланта -8 %, лигатурный свищ -4 %; при этом осложнения привели к потере импланта в 14 (56 %) случаях [8]. P. Osemlak (2018) в серии наблюдений 290 пациентов до 18 лет сообщает о частоте осложнений в раннем периоде -15 % и в позднем периоде -8 % [9].…”

Section: Introductionunclassified

“…Orchiectomy + testicular endoprosthesis 17(12,5) 23(14,7) Удаление культи семенного канатика + эндопротезированиеRemoval of the stump of the spermatic cord + endoprosthetics 3 (2,2) 14(8,9) Удаление лигатурной гранулемы культи + эндопротезированиеRemoval of ligature granuloma of the stump + endoprosthetics -1 (0,6)…”

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Complications of testicular prosthetics: analysis of causes, surgical tactics, ways of prevention

Shormanov,

Shchedrov,

Spasskaya

et al. 2023

Androl. genit. hir.

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Background. Testicular prosthetics, despite the apparent simplicity of the technique of performing the operation, often leads to complications. At the same time, the spread of data from different authors on the frequency and structure of complications is extremely large. At the same time, the factors indicated by the authors as the causes of complications often contradict each other, and, as a rule, are not analyzed, therefore, methods of prevention and therapeutic tactics are not clearly defined today.Aim. To analyze the frequency and structure of complications during testicular prosthetics in patients over 18 years of age and adolescent children, as well as to suggest optimal ways to prevent the identified complications.Materials and methods. The results of testicular prosthetics were analyzed in 292 patients aged 12–59 years in the period 2007–2022. Various complications were found in 27 patients (9.24 %), including in the adolescent group (12–17 years) – in 13 (8.33 %) patients out of 156, in adults – in 14 (10.29 %) out of 136. MIT implants were used in 116 cases (adults – 54, adolescents – 62) and Promedon implants – in 176 cases (adults – 80, adolescents – 96). Data processing was carried out in the Statistica 20.0 program. The p <0.05 level was considered statistically significant.Results. The most common complications include implant extrusion (22.2 %) and surgical hemostasis disorders (29.6 %), they are also the most difficult to correct and often lead to the need to remove the implant. The use of antibacterial therapy by the course does not reduce the risk of complications, the absence of antibiotic prophylaxis increases the incidence of complications by 3.9 % in the adult group and by 2.28 % in the adolescent group. The most rational single perioperative antibiotic prophylaxis. The frequency of complications when using MIT implants is higher (n = 17) than Promedon (n = 10). The incidence of complications is significantly higher in the group of patients who underwent prosthetics for more than three years after primary orchectomy or in an initially hypoplasized scrotum.Conclusion. Complications of testicular prosthetics are 8.33–10.29 %. The structure is dominated by complications of hemostasis and implant extrusion, they are also the cause of the greatest number of repeated interventions and the reason for the removal of the implant. A number of factors influence the formation of complications – access, the scheme of antibacterial therapy/prevention, the implantable material, the period after the initial operation. The most rational is the use of a modern silicone implant for prosthetics 6–12 months after orchectomy with suprascrotal access with a single perioperative antibiotic prophylaxis. The risk of the most dangerous and frequent complications can be leveled by using preventive measures.

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The use of testicular prostheses in boys

Cited by 6 publications

References 17 publications

Concurrent placement of the testicular prosthesis in children following orchiectomy/testicular loss

Concurrent placement of the testicular prosthesis in children following orchiectomy/testicular loss

Testicular torsion: a modified surgical technique for immediate intravaginal testicular prosthesis implant

Complications of testicular prosthetics: analysis of causes, surgical tactics, ways of prevention

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