Testicular Implants | Prostheses

Absent or lost testicle(s) due to trauma, surgery or disease can have a very bad impact on the life of an individual. In poorly managed cases, the affected person may experience difficulty in maintaining personal as well as sexual relationships. All such individuals are good candidates for testicular prostheses (or testicular implants) to restore their normal quality of life. It is however imperative to mention that these implants can only enhance the aesthetic appearance of your groin area and does not offer any help to restore the usual functions of testicles.

Who Are Suitable Candidates For Testicular Prostheses?

Individuals with following indications should discuss with their healthcare professional regarding testicular implants.

• Children with undescended testes or those who underwent orchiectomy for other indications such as injury, tissue death, etc.
• Torsion of testes (twisted testicles).
• Individuals undergoing surgery for gender change.

Testicular prostheses/implants can also offer help in men who have cosmetic issues with their testicles (such as extremely small testicles, unequal or disproportionate testicles or non- functioning testicles). In addition, adults with testicular cancer, testicular injury or torsion of testes are also ideal candidates for testicular implants.

Are There Any Other Alternatives To Implants?

Testicular implants adds up to the aesthetic look. The alternatives to these implants are procedures like subcapsular orchiectomy, which involves the removal of testicle tissue, while leaving the capsule empty. This procedure is not suitable for men with testicular cancer. Another option is to leave the scrotum fully or partially empty. Subcapsular orchiectomy yields smaller appearance to the scrotum but is considered better to empty scrotum aesthetically.

Are There Any Contraindications To Testicular Implant Surgery?

Testicular implants are not a viable option for men with:

• An active testicular infection
• A testicular or prostatic cancer

This is mainly because, the risk of complications increases significantly in all such cases.

Considerations About The Procedure

Like other medical devices/implants, testicular prostheses are also associated with certain considerations. It is the duty of surgeon to discuss all the pros and cons of procedure with the patients. Certain considerations and concerns regarding the procedure are:

• There is always a risk of rejection, rupture or leakage of implant which may require a revision surgery for the reversal ofprocedure. Phan reported a case of a 55-year old male who reported with the spontaneous rupture of testicular implant after 33 years of implantation. The patient reported with pain in the scrotum and was managed with the removal of implant without any residual complications or adverse effects (2).
• Patient might require adjustment or replacement with a new one implant. This is especially true in case of young children who may require new and larger implants when they grow up.

Are There Any Side Effects To Watch Out For?

Testicular implants can produce scarring (which is also referred to as the capsule) around the implant. This capsule may start to contract, leading to a condition known as fibrous capsular contracture. This condition can harden the implant and may also present with disturbing symptoms such as localized discomfort and pain.

Safety

Following is the safety data and statistics obtained from a recent clinical study after performing the procedure:

• About 10% patients reported pain and discomfort after the testicular implant surgery.
• Approximately 3% patient reported a temporary swelling at the site of implantation.
• Only 1% were diagnosed with self-limiting infection at the implant site.
• 2% patients opted for the extrusion of implant.
• Displacement of implant occurred in 2% patients.
• One out of thirty patients had to get their implants removed within one year due to extrusion of implants.

Effectiveness

Data regarding the effectiveness of implants suggested that:

• Physical appearance and firmness of implants is fairly similar to the real testicles.
• The size of implants imitate the natural ones.
• Patients reported high satisfaction scores after testicular implant surgery and suggested that their confidence and self-esteem has significantly improved after the implantation.

References

1. Seymour-Smith, S. (2013). A reconsideration of the gendered mechanisms of support in online interactions about testicular implants: a discursive approach. Health Psychology, 32(1), 91.

2. Phan, Q. B., Koutlidis, N., Duperron, C., Mourey, E., Michel, F., & Cormier, L. (2016). Management of Testicular Silicone Gel-Filled Prosthesis Rupture: Case Report of a Rare Event and a Review of the Literature. Case reports in urology, 2016.

3. Kogan, S. (2014). The clinical utility of testicular prosthesis placement in children with genital and testicular disorders. Translational andrology and urology, 3(4), 391.

4. Selvaggi, G. (2015). Surgical therapy: scrotal reconstruction in female-to-male transsexuals. In Management of Gender Dysphoria (pp. 295-301). Springer Milan.