The Clinical Utility of Testicular Prosthesis Placement in Children With Genital and Testicular Disorders

Stanley Kogan

Disclosures

Transl Androl Urol. 2014;3(4):391-397. 

In This Article

Abstract and Introduction

Abstract

Testicular prosthesis placement is a useful important adjunctive reconstructive therapy for managing children with testicular loss or absence. Though these prostheses are functionless, experience has shown that they are extremely helpful in creating a more normal male body image and in preventing/relieving psychological stress in males with a missing testicle. With attention to details of implant technique, excellent cosmetic results can be anticipated in simulating a normal appearing scrotum.

Introduction

Testicular prosthesis placement constitutes a useful and important adjunctive component for managing children with many testicular disorders. Conditions occurring in childhood such as unilateral or bilateral testis absence (monorchia, bilateral anorchia), acquired testis loss from trauma, cancer or spermatic cord torsion, or removal of atrophic testes following herniotomy or orchidopexy are common conditions where prosthesis placement may be considered. Placement in children with various disorders of sexual development undergoing masculinizing genitoplasty constitutes another group. Though these prostheses are, of course functionless, clinical experience has shown that they are extremely beneficial in creating a more normal male body image and in preventing/relieving psychological stress in males with a missing testicle.

The history regarding development and use of testicular prostheses is of interest, from both historical as well as scientific perspectives. A variety of materials have been used over the years to create these prostheses, including metal (vitallium), rubber, plastic, polyurethane, glass and silicone, to name only some.[1] Modern-day history dates to the introduction of a silicone-shell liquid silicone filled prosthesis introduced by Lattimer et al. in 1973.[2] This prosthesis was the first to have a more natural, compressible feel and was widely used over the next 20 years though it was noted at times that this prosthesis might leak liquid silicone. In 1993 concerns emerged regarding the safety of silicone implants of all types due to a suspicion of associated connective tissue disorders, and the U.S. Food and Drug Administration (FDA) mandated cessation of manufacture of all implants till further documentation of their safety and efficacy was confirmed. Their concerns are cited in detail below as they represent an insight into issues involved with the contemporary evolution of testicular implants. Additionally, an excellent review paper summarizes this interesting long history as well as elaborating on the use of testicular prostheses in general.[1]

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