Hao Tong-Li, Chen Peng
Department of Urology, General Hospital of Chinese People's Liberation Army, Beijing, China.
BMC Res Notes. 2011 Apr 2;4:99. doi: 10.1186/1756-0500-4-99.
Testicular prosthesis has been applied clinically for decades, and implantation of testis prosthesis under the tunica albuginea has been considered to be the standard method in the most of the reports. However, postoperative scrotal appearance, the mobilization and the palpitation of the prosthesis are not always satisfactory to all the patients. Modifications in surgical techniques might be necessary to bring improvements to the clinical outcomes in testicular prosthesis implantation.
In a group of 9 beagle dogs in this study, an orchiectomy succeeded with a testicular prosthesis implantation under the tunica vaginalis, and a complete mechanical denudation of the testicular parenchyma succeeded with an implantation under the tunica albuginea were performed, respectively. Histopathological evaluations of the scrotal tissues and the implants, which were made at the end of the follow-up, showed that all the tested animals lived uneventful lives during the follow-up period, and no rejections or infections were found. Prostheses implanted under the tunica vaginalis showed a more satisfying mobilization and palpation than those implanted under the tunica albuginea. Chronic inflammation in the para-prosthesis tissues with vascular proliferation and fibrinogenesis were more common in the "under tunica albuginea" group than that in the "under tunica vaginalis" group, although differences in fibrinogenesis between the two groups were found to be statistically insignificant.
In this comparative study, we have re-evaluated the two most popular implantation methods of testicular prosthesis, the "under the tunica albuginea" and the "under the tunica vaginalis" pathways, in animal models. We found that the testicular prosthesis were all well tolerated, but the prosthesis implanted under the tunica vaginalis showed a more satisfying result concerning appearance, palpability, and histopathological findings than that of the "under the tunica albuginea" group. The "under the tunica vaginalis" method might become a more practical method for future testicular prosthesis implantation.
睾丸假体已在临床上应用了数十年，在大多数报告中，白膜下植入睾丸假体被认为是标准方法。然而，术后阴囊外观、假体的活动度和可触及性并非总能让所有患者满意。可能需要对手术技术进行改进，以改善睾丸假体植入的临床效果。
在本研究的一组9只比格犬中，分别成功进行了睾丸切除术并在鞘膜下植入睾丸假体，以及成功进行了睾丸实质完全机械剥脱并在白膜下植入。随访结束时对阴囊组织和植入物进行的组织病理学评估显示，所有受试动物在随访期间生活平稳，未发现排斥反应或感染。鞘膜下植入的假体比白膜下植入的假体在活动度和可触及性方面更令人满意。尽管发现两组之间的纤维蛋白形成差异无统计学意义，但“白膜下”组假体周围组织的慢性炎症伴血管增生和纤维蛋白形成比“鞘膜下”组更常见。
在这项比较研究中，我们在动物模型中重新评估了睾丸假体两种最常用的植入方法，即“白膜下”和“鞘膜下”途径。我们发现睾丸假体均耐受性良好，但鞘膜下植入的假体在外观、可触及性和组织病理学结果方面比“白膜下”组更令人满意。“鞘膜下”方法可能成为未来睾丸假体植入更实用的方法。
