Tawfik, M, Zakkar, B, Raheem, O.A.

Testicular prothesis, scrotal surgery

Testicular implants have been widely available over the last 50 years. Since then, surgeons have strived to make the prosthesis as realistic as they could.1 Recently, Coloplast developed the Torosa® Saline-Filled Testicular Prosthesis, the only FDA approved testicular implant.2 This video shows the step-by-step surgical procedure for the implantation of the prosthesis in an adult male patient with a prior simple orchiectomy of the left testis. Testicular prosthesis implantation may be a simple and quick procedure, but it can have a lasting positive impact on the patient’s psychosocial wellbeing when compared to men who elected to not undergo this procedure.2 The purpose of this video is to be used as a guide for students and residents to gain a better understanding on how to complete this procedure. The approach taken in the video was a standard midline raphae scrotal incision, dissecting through the deep dartos layer to create a left sided subdartos pouch. A large sized prosthesis filled with normal saline was used to match the consistency of the normal contralateral testis. Once the pouch was created, the prosthesis was implanted. The prosthesis was then lined up and tied down to the gubernaculum to stabilize its position with sutures. Finally, the dartos layer and the skin were closed. The procedure was completed without complications. The patient’s recovery was uneventful and is awaiting follow-up.

1. Girsdansky J, Newman H.F. Use of a vitallium testicular implant. Am J Surg. 1941;53:514. doi: 10.1016/S0002-9610(41)90676-1

2. Torosa® Saline-Filled Testicular Prosthesis. Available online: https://iu.coloplast.us/products/torosa-testicular-implants/

3. Skoogh J, Steineck G, Cavallin-Ståhl E, et al. Feelings of loss and uneasiness or shame after removal of a testicle by orchidectomy: a population-based long-term follow-up of testicular cancer survivors. Int J Androl. 2011;34(2):183-192. doi:10.1111/j.1365-2605.2010.01073.x

4. Dieckmann KP, Anheuser P, Schmidt S, et al. Testicular prostheses in patients with testicular cancer - acceptance rate and patient satisfaction. BMC Urol. 2015;15:16. Published 2015 Mar 13. doi:10.1186/s12894-015-0010-0