Institute of Urology, Rabin Medical Center, Beilinson Campus, Petach Tikva, Israel.
J Urol. 2011 Dec;186(6):2249-52. doi: 10.1016/j.juro.2011.07.075. Epub 2011 Oct 19.
We assessed the perspectives of patients with testicular cancer on the placement of a prosthesis at orchiectomy and identified predictors of long-term satisfaction.
Consecutive patients who underwent radical orchiectomy for testicular cancer in 1995 to 2009 were asked to complete a telephone questionnaire covering background demographics, subjective assessment of implant characteristics, impact of the prosthesis on daily and sexual activities, and overall satisfaction with outcome.
A total of 98 patients completed the interview, of whom 86 (87%) received a prosthesis. Median interval from surgery to interview was 6 years and most men were married or engaged in a steady relationship. The majority found the prosthesis to be of appropriate weight and size. The main complaints were firm consistency (70%) and high scrotal position (39%), both of which were significantly associated with lesser patient satisfaction (p = 0.03) and regret of the decision to accept an implant (p = 0.02). Approximately 15% of patients indicated the prosthesis interfered with physical exercise or sexual activity. Younger age at surgery was associated with a greater likelihood of accepting a prosthesis but not with long-term satisfaction. Overall the outcome was rated good to excellent in 77% of cases.
Patients with testicular cancer scheduled to undergo orchiectomy should be offered a testicular prosthesis, and reassured that complications are few and that expected long-term satisfaction is fair. Optimizing the texture of the implant and its position in the scrotum may improve outcome. However, patients should be counseled about possible adverse implications in terms of physical exercise or sexual activity.
评估睾丸癌患者对睾丸切除术时假体放置的看法，并确定长期满意度的预测因素。
连续纳入 1995 年至 2009 年期间因睾丸癌行根治性睾丸切除术的患者，要求他们通过电话完成问卷，内容包括背景人口统计学、对植入物特征的主观评估、对假体对日常和性生活的影响，以及对治疗结果的总体满意度。
共有 98 例患者完成了访谈，其中 86 例（87%）接受了假体。手术至访谈的中位时间为 6 年，大多数患者已婚或处于稳定的恋爱关系。大多数患者认为假体的重量和大小合适。主要抱怨是假体的硬度（70%）和阴囊位置高（39%），两者均与患者满意度较低（p = 0.03）和对接受植入物的决定感到后悔（p = 0.02）显著相关。约 15%的患者表示假体影响了体育锻炼或性生活。手术时年龄较小与接受假体的可能性增加有关，但与长期满意度无关。总体而言，77%的患者对治疗结果评价良好或优秀。
拟行睾丸切除术的睾丸癌患者应被提供睾丸假体，并应告知其并发症较少，且预期的长期满意度尚可。优化假体的质地及其在阴囊中的位置可能会改善治疗结果。但是，应告知患者在体育锻炼或性生活方面可能存在的不良反应。
