Background: The removal of a testicle in a child, teenager or adult is done for a variety of medical reasons. The three Ts (trauma, tumors and torsion) make up the major reasons for an often urgent need for removal of a testicle. Its replacement is usually not done at the removal due to swelling, the uncertainty of if any future treatments will be needed and the increased risk of infection.
Testicle implant replacement can typically done within six months after the removal surgery. The question then becomes what type of implant to use and size. Implant options are between saline-filled and solid silicone. Both can be effective space fillers but silicone remains the superior choice because it is ultrasoft (feels similar to the opposite testicle), will never fail or need to be replaced and has a much wider variety of size options.
Silicone testicle implants are available in standard sizes as well as can be made custom. Standard sizes go up to 5.0cm length which works for most men. Larger size can be made custom for each patient of desired.
Case Study: This male lost his left testicle at age 15 due to torsion. He presented twenty years later for replacement.
Under general anesthesia a small portion of his original removal incision on his scrotum was reopened and a pocket made for the new left testicle. The 5.0cm size implant was a good match for the other side and was inserted and the incision closed without tension.
When a testicle implant is inserted it immediately occupies a space that stretched out the scrotum with a lifting effect. It will take several months for the scrotal tissues to relax and the new testicle to hang more naturally. The thin very elastic tissues of the scrotum assure that will happen, some patients sooner than others.
Case Highlights:
1) Many men go a long time after loss of a testicle before considering its replacement, presumably due to lack of awareness and adequate information about the procedure.
2) Standard ultrasoft solid silicone implants have the most natural feel and will last a lifetime without device failure or need for replacement.
3) Most testicle implants can be placed through the original incisions that were used for the testicle removal.
Dr. Barry Eppley
Indianapolis, Indiana