Elder J S, Keating M A, Duckett J W
Division of Urology, Children's Hospital of Philadelphia, University of Pennsylvania School of Medicine.
J Urol. 1989 Jun;141(6):1413-5. doi: 10.1016/s0022-5347(17)41328-0.
Traditionally, the parents of young boys with an absent testis are advised to let the child decide whether he wants a testicular prosthesis after he enters puberty. Unfortunately, the decision by an adolescent to undergo prosthesis insertion often is made only after experiencing ridicule and embarrassment about the genital appearance. Accordingly, we have offered to implant an infant size prosthesis in patients with cryptorchidism when inguinal and abdominal exploration demonstrates that the testis is absent. A total of 41 boys less than 5 years old with an absent testis underwent simultaneous insertion of a testicular prosthesis. The only complication was a superficial wound infection that did not necessitate removal of the prosthesis. Two boys report mild scrotal discomfort. In long-term followup 91 per cent of the families rated the cosmetic appearance as "good" and 94 per cent were content with the decision regarding placement of a prosthesis. Although many assume that these boys will desire a larger prosthesis after puberty, this consideration seems to be irrelevant. Longer followup will be necessary to ascertain whether this approach alters the psychosexual development of these patients. We believe that young boys with an absent testis should be considered for simultaneous testicular prosthesis insertion at inguinal exploration or orchiectomy.
传统上，对于睾丸缺失的小男孩，其父母会被建议让孩子在进入青春期后决定是否想要植入睾丸假体。不幸的是，青少年决定接受假体植入往往是在经历了因生殖器外观而遭受的嘲笑和尴尬之后才做出的。因此，当腹股沟和腹部探查证实睾丸缺失时，我们会为患有隐睾症的患者植入婴儿尺寸的假体。共有41名5岁以下睾丸缺失的男孩同时接受了睾丸假体植入。唯一的并发症是浅表伤口感染，无需取出假体。两名男孩报告有轻度阴囊不适。在长期随访中，91%的家庭对外观评价为“良好”，94%的家庭对假体植入的决定感到满意。尽管许多人认为这些男孩在青春期后会想要更大的假体，但这种考虑似乎并不相关。需要更长时间的随访来确定这种方法是否会改变这些患者的性心理发育。我们认为，对于睾丸缺失的小男孩，在腹股沟探查或睾丸切除时应考虑同时植入睾丸假体。
