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Implantation of Testicular Prostheses (silicone replacement of testicles)

Implantation of Testicular Prostheses /silicone replacement of testicles/ can simply aesthetically solve cases of loss or inborn nondevelopment of one or both testicles. Except the actual cosmetic handicap these cases bring also secondary psychic problems and feelings of inferiority for the affected men.

Usually those are young men, so there are no doubts about the suitability of the surgical procedure, when it is requested and technically possible. According to availability, harmlessness and quality of testicular prostheses this procedure should be a part of repertoire of every experienced plastic surgical clinic.

When is implantation of Testicular Prostheses recommended?

In these cases:

  • cases after injuries with the need of orchiectomy (removal of testicles)
  • cancer processes with the need of funicular orchiectomy (removal of testicle with spermatic cord)
  • inflammatory mostly absceding states with the need of orchiectomy
  • undescended testicle with the need of removal
  • inborn undeveloped testicle etc.

Relative indication present states of hormonal treatment (such as for example bothsided orchiectomy within treatment of prostate cancer) or cases associated with the loss of both testicles within sexological and psychiatric treatment.

Implant (silicone replacement)

The used silicone, respectively gel implants are practically identical to more common breasts implants. Most of the producers create products of real shape and palpation. They are mainly offered in five sizes indicated in cm or cm3.

The implants are usually equipped with fixation loop against shift towards inguinal canal (groin). Some producers make two types of surfaces - smooth and rough. The package is sterile, with sterility indication and no preparations are needed. The products are naturally certified with identification label for the implant carrier.

Surgical approach

We use two surgical approaches:

1.inguinal
2.scrotal (from the area of scrotum)

The inguinal approach is used mainly at urological departments. Those are planned surgeries caused by tumors. Here it is necessary to remove testicle even with spermatic cord right from this higher incision. The same approach is by insertion of implant by removal of inborn underdeveloped inferior testicle in the area of inguinal canal.

The advantage of this approach is a possibility of inserting the prosthesis at the same time with original procedure. Disadvantage presents worse availability to form enough room for the testicle in the scrotum and the impossibility of usage of fixation loop for the implant. The communication between scrotal cavity and groin must be therefore closed with circular suture.

The second, scrotal approach is used in all other cases of mentioned indications. Those are mainly cases, when it was not possible to insert the implant during first original procedure. The advantage is the possibility of good preparation of the cavity in scrotum for implant insertion and the possibility of good fixation to dermis of scrotum.

Surgical procedure of Testicular Prostheses

The procedure is performed under spinal or short general anaesthesia; it is usually an outpatient procedure. After choosing the right approach an incision is lead of a length, which is necessary for inserting the implant into the scrotum. Then we usually make a room for the prosthesis by blunt preparation. The implant is inserted under strictly aseptic conditions and is fixed with one of the possibilities mentioned above, so that the position and height of the implant look naturally. Then we close the dermis with absorbable material, epidermis usually with non-absorbable sutures. The wound is covered sterilely. The intradermal suture is removed after approximately seven days.

Advantages of the implantation of Testicular Prostheses

  • simplicity
  • possibility of outpatient performance
  • shape and palpation realness
  • the possibility to choose the size
  • practically hundred percent of tolerance
  • relative price affordability of the material

Disadvantages of the procedure

Slightly fixed position of the testicle in the scrotum compared to the other side without the possibility of natural reaction on temperature changes.

More information about implantation of Testicular Prostheses:

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MUDr. Martin Tománek

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