What is a testicular prosthesis?
A prosthesis is any artificial device used to replace a body part. For many people, the first type of prosthesis that probably pops into their mind is one for a missing leg or arm. However, there are other types of prosthesis available. When a male is either born without a testicle or must have one removed because of an injury or disease, a testicular prosthesis can be used to fill in the empty space in the scrotum. The scrotum is the sac that holds the testicles.
A prosthesis is used only to improve appearance and calm psychological fears. It doesn’t have any functions of a real testicle. More often than not, requests for a testicular prosthesis come from men who are born with a testicle and later lose it, rather than someone who's always been missing a testicle.
Testicular prostheses have been in use since the 1940s. In the past, they were made of a variety of materials. Now, they are mainly made of silicone rubber and are filled with either silicone gel or saline (salt water). A testicular prosthesis will have the weight, shape and feel similar to a normal testicle. It’s also available in different sizes so that a good match can be made to your body.
What conditions or events can cause a missing testicle?
There are several reasons that someone might be missing a testicle. A few possible reasons that you could be missing a testicle can include:
- The testicle being malformed or missing at birth.
- It being surgically removed due to injury, such as severe torsion (twisting).
- There being a failure to descend into the scrotum.
- The testicle being removed due to infection.
- The testicle being removed in order to treat testicular cancer.
A testicular prosthesis may also be considered as a part of female-to-male gender reassignment surgery
What are the characteristics of a good testicular prosthesis?
The ideal testicular prosthesis should:
- Have no chemical reactivity.
- Not cause inflammation.
- Resist mechanical stress.
- Be sterile.
- Be able to take on and hold the correct shape.
- Feel comfortable.
What procedure is used to implant a testicular prosthesis?
When you’re deciding to have this procedure, it’s important to find a surgeon who specializes in testicular prosthesis implantation. Talk to the surgeon about all of your questions and learn all of the details of the procedure beforehand.
In general, the procedure to implant a testicular prosthesis involves:
- Placing the patient under either general (whole body) or local anesthesia (pain-blocking medication) that will prevent any feelings of pain in the lower part of the body during the procedure.
- Making an incision in the lower part of the groin or upper scrotum.
- Creating a pouch for the prosthesis.
- Sewing or otherwise fixing the implant into place in the correct position.
- Closing the incision with stitches.
This procedure is usually performed as an outpatient surgery.
Risks / Benefits
Who is at high risk of complications from testicular prosthesis implantation?
There are always risks when you have a medical procedure. However, if you have certain conditions before your procedure, you may have a higher chance of developing complications than those without medical conditions.
Medical conditions that could cause you to face a higher risk of complications can include:
- Having diabetes or a suppressed immune system. People with these conditions have an increased risk of infection.
- Having an existing infection anywhere in your body.
- Having had a previous surgery on the scrotum.
What are possible complications of testicular prosthesis implantation surgery?
There are several possible complications of testicular prosthesis implantation surgery, including:
- Hematoma (pooling of blood in the scrotum).
- Dissatisfaction with appearance following surgery.
- Scarring around the implant.
- Shifting of the prosthesis out of position.
- Rupture or leaking of the prosthesis.
- The prosthesis being expelled from the body (this usually means that the device is infected).
Recovery and Outlook
What can be expected following testicular prosthesis implantation surgery?
After your procedure, you will need a little time to recover. A few things you can expect might include:
- Pain, discomfort and tenderness in the surgical area for at least the first 24 to 48 hours. Your healthcare provider will prescribe pain medicine as needed.
- Bandages will remain in place for at least a few days.
- Your ability to urinate should not be affected.
- The use of supports for the scrotum may be advised.
- Antibiotics, especially in cases of high risk of infection, may be needed.
- Avoidance of lifting heavy weights, bike riding or strenuous physical activity for about one month following surgery.
What is the outlook for someone with a testicular prosthesis?
There have been concerns about cancer and connective tissue disease resulting from the use of silicone implants. This has been the case with some silicone breast implants. Generally, the prostheses used in this procedure are either a silicone block (hard silicone throughout) or saline-filled. For this reason, the risks stated above for silicone gel-filled breast implants are not a concern. Talk to your healthcare provider about the type of implant used in your procedure and any risks associated with that implant.