Testicular prosthesis placement: a new technique

Abstract

the prosthesis can be placed within the scrotum and the Indications wound closed (Fig. 3). Testicular prostheses are usually inserted for cosmetic reasons after orchidectomy and as such, the key to the Comparison with other methodsprocedure is the correct positioning of the prosthesis in the normal dependent location within the scrotum. We A few techniques have been described to optimise intrascrotal placement. The use of a vaginal speculum, describe a technique that ensures optimal positioning and prevents postoperative migration.placed in the inguinal wound, to identify the most dependent position also has the advantage of dilatation of the scrotal neck [1]. However, the size of the speculum MethodUsing an inguinal approach, the neck of the scrotum is dilated with Hegar dilators of increasing size until it will admit the prosthesis. The largest dilator is then pushed downwards to the most dependent part of the scrotum (Fig. 1a). A second dilator is then placed on the scrotal skin, in opposition to the intrascrotal dilator, clamping the most dependent part of the scrotum between the dilators (Fig. 1b). The dilators are then moved cephalad together, such that the most dependent part of the scrotum is invaginated over the second dilator and lies outside the inguinal wound (Fig. 2a). The prosthesis is then anchored to this area using a 3/0 polyglactin suture (Fig. 2b).

Testicular implants and patient satisfaction: a questionnaire‐based study of men after orchidectomy for testicular cancer

“…The length-to-width ratio decreases from small to large such that the large implant (mostly used in adults) is rounder. Third, care must be taken to prevent the implant from being too high in the scrotum [4]. The latter report gives a clear explanation of how to avoid the`high riding' testis.…”

Simple placement of prosthetic testes in children

“…Various complications associated with insertion of testicular prostheses include infection, haematoma, failure of adequate scrotal distension with secondary displacement of the prostheses in a higher position, wound dehiscence with spontaneous extrusion of the prosthesis, transient or persistent scrotal contraction, rupture of the silicon envelope and persistent pain [5,6]. In an attempt to achieve good cosmetic results various techniques like use of a vaginal speculum [7], an invagination technique using two Hegar's dilators [8] and the use of a Foley catheter [9] have been described. All these techniques involves fixation of the prostheses to the base of the scrotum.…”

Testicular prostheses: a new technique for insertion

“…The use of both a vaginal speculum [2] and a Hegar dilator [3] have been described to ensure a good cosmetic result from inserting a testicular prosthesis. Our technique has advantages over these; the use of a catheter balloon in the scrotal space prevents overstretching of the scrotal neck, hence reducing the risk of the prosthesis moving upwards during changes in temperature.…”