Clifford Thomas G, Burg Madeleine L, Hu Brian, Loh-Doyle Jeffrey, Hugen Cory M, Cai Jie, Djaladat Hooman, Wayne Kevin, Daneshmand Siamak
USC Institute of Urology, USC/Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA.
Department of Urology, Loma Linda University, Loma Linda, CA.
Urology. 2018 Apr;114:128-132. doi: 10.1016/j.urology.2017.12.006. Epub 2017 Dec 27.
To determine patient satisfaction with testicular prostheses (TP) for testicular cancer. Reconstruction represents an important part of surgical oncology, yet placement of TP following orchiectomy is infrequently performed. Improved data on patient satisfaction with TP would help in counseling patients with testicular cancer.
Forty patients who underwent orchiectomy and TP placement for testicular cancer participated in a survey that was blinded to the providers in an outpatient clinic (2012-2014) to evaluate TP satisfaction. Categorical variables associated with satisfaction were compared using the Fisher's exact test.
Median age at TP placement was 31 years (17-59). Most patients had their prosthesis in place for >1 year (81%) at the time of the survey. No patient reported complications from the TP and none underwent explantation. All patients felt that being offered an implant before orchiectomy was important. Overall, 33 patients (82.5%) rated the TP as good or excellent, and 35 men (87.5%) would have the prosthesis implanted again. Thirty-seven patients (92.5%) found the TP to be comfortable or very comfortable. However, 44% considered the TP too firm and 20% felt the position was not appropriate. Appropriate size, appropriate position, and TP comfort were significantly associated with good or excellent overall TP satisfaction (P < .05).
Overall satisfaction with testicular implants after orchiectomy for testicular cancer is high. Patients should be offered a testicular prosthesis, especially at the time of orchiectomy. Efforts should be made to optimize implant firmness, and care should be given to proper size selection and positioning.
确定睾丸癌患者对睾丸假体（TP）的满意度。重建是外科肿瘤学的重要组成部分，但睾丸切除术后放置TP的情况并不常见。关于患者对TP满意度的更多数据将有助于为睾丸癌患者提供咨询。
40例因睾丸癌接受睾丸切除术和TP植入的患者参与了一项调查，该调查在门诊诊所对提供者保密（2012 - 2014年），以评估TP满意度。使用Fisher精确检验比较与满意度相关的分类变量。
TP植入时的中位年龄为31岁（17 - 59岁）。大多数患者在调查时其假体已放置超过1年（81%）。没有患者报告TP出现并发症，也没有人进行取出术。所有患者都认为在睾丸切除术前提供植入物很重要。总体而言，33例患者（82.5%）将TP评为良好或优秀，35名男性（87.5%）愿意再次植入假体。37例患者（92.5%）认为TP舒适或非常舒适。然而，44%的患者认为TP太硬，20%的患者觉得位置不合适。合适的尺寸、合适的位置和TP舒适度与总体TP满意度良好或优秀显著相关（P < 0.05）。
睾丸癌睾丸切除术后对睾丸植入物的总体满意度较高。应向患者提供睾丸假体，尤其是在睾丸切除时。应努力优化植入物的硬度，并注意选择合适的尺寸和正确定位。
