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20-11-2011 | Surgery | Article

Most cancer patients satisfied with testicular prosthetic outcomes


Free abstract

MedWire News: More than three-quarters of patients who receive testicular prostheses following radical orchiectomy are satisfied with the functional and cosmetic outcome, research shows.

Patients receiving the prosthetic should be "reassured that complications are few and that expected long-term satisfaction is fair," write Ofer Yossepowitch (Rabin Medical Center, Israel) and colleagues in the Journal of Urology.

In treating testicular germ cell tumors, urologists are becoming more aware of the physiologic, psychologic, and social aspects of treatment. With surgery, physicians are making increasing efforts to restore the appearance of the scrotum with a testicular prosthetic.

Testicular prostheses are commonly implanted following orchiectomy, but few studies have evaluated men's perceptions of the implant. In addition, long-term satisfaction with testicular prosthetics among cancer survivors is virtually unknown.

Consecutive patients undergoing radical orchiectomy between 1995 and 2009 (n=98) were asked to complete a telephone questionnaire about their satisfaction with the implant, as well as the impact of the prosthesis on daily and sexual activities.

In total, 86 patients had received prostheses. Most patients complained about the firm consistency of the prosthetic, and 39% complained about the high scrotal position, both of which were significantly associated with less satisfaction (p=0.02). However, in terms of weight and size, the majority of patients were satisfied.

"These findings prompted us to modify the surgical technique in 2005 and substitute a softer implant," report Yossepowitch and colleagues.

More than 80% of patients felt the prosthesis was comfortable, or very comfortable, but 15% of patients found it uncomfortable during sexual activity. In addition, 5% found the prosthetic uncomfortable during physical activity.

Nine patients regretted the decision to have the prosthesis and two patients subsequently had it removed.

Younger patients were more likely than older patients to opt for a prosthesis at the time of surgery, and did this in an effort to preserve body image and self-esteem.

The researchers did not observe a correlation between long-term satisfaction and patient age at the time of surgery, time elapsed since the insertion of the prosthesis, or age at the time of the interview.

"Interestingly, being married or a partner in a steady relationship appeared to have no impact on the initial preference for a prosthesis or on long-term satisfaction," according to Yossepowitch and colleagues.

Based on their data, the researchers suggest that patients with testicular cancer scheduled for radical orchiectomy be offered the option of testicular prosthesis, and should be reassured about the low complication rate and the satisfaction of other patients.

They should also be counseled about possible adverse implications for physical exercise or sexual activity.

By MedWire Reporters

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