Emmanuel Anthony, Kanthabalan Abi, Alexander Cameron, Bhatt Nikita, Chan Vinson, Kalejaiye Odunayo, Narahari Krishna, Kasivisvanathan Veeru, Shabbir Majed
Department of Urology Freeman Hospital Newcastle upon Tyne UK.
Department of Urology Worcestershire Royal Hospital Worcester UK.
BJUI Compass. 2024 Nov 26;6(1):e465. doi: 10.1002/bco2.465. eCollection 2025 Jan.
This study aimed to assess current international clinician practices, attitudes and barriers related to testicular prosthesis implantation in patients with testicular cancer at the time of radical inguinal orchidectomy.
An international online survey of urologists who perform radical orchidectomy for testicular cancer was developed. The recruitment process used social media and the emailing lists of national urological societies. Responses were collected between 10 February 2021 and 31 May 2021. The primary outcome was the proportion of urologists who always offered testicular prosthesis implantation to patients undergoing radical orchidectomy. Secondary outcomes included the reasons for not offering testicular prosthesis implantation.
A total of 393 respondents took part in the online survey; of these, the majority were from the UK (66%), with the remaining international respondents (34%) from six different continents. Urologists (53%) reported they always offer testicular prosthesis implantation. Of those that offered testicular prosthesis implantation, 28% did so as a secondary procedure after radical orchidectomy, rather than the time of radical orchidectomy (72%). The most frequently selected reasons for not offering testicular prosthesis implantation included concerns about delaying chemotherapy (41%), infection (33%), impaired cosmesis (17%) and lack of availability (17%).
Despite evidence confirming the safety and the psychological benefit of testicular prosthesis implantation during radical orchidectomy, current international practice suggests just over half of urologists always offer this to their patients. Increased clinician awareness of the low risk of complications and high patient satisfaction may act to reduce the perceived barriers in offering testicular prosthesis implantation.
本研究旨在评估目前国际上临床医生在根治性腹股沟睾丸切除术中为睾丸癌患者植入睾丸假体的实践情况、态度及障碍。
开展了一项针对为睾丸癌实施根治性睾丸切除术的泌尿外科医生的国际在线调查。招募过程利用了社交媒体和国家泌尿外科学会的邮件列表。在2021年2月10日至2021年5月31日期间收集回复。主要结果是在根治性睾丸切除术时总是为患者提供睾丸假体植入的泌尿外科医生的比例。次要结果包括不提供睾丸假体植入的原因。
共有393名受访者参与了在线调查；其中，大多数来自英国（66%），其余国际受访者（34%）来自六个不同的大洲。泌尿外科医生报告称他们总是提供睾丸假体植入的占53%。在那些提供睾丸假体植入的医生中，28%是在根治性睾丸切除术后作为二次手术进行的，而不是在根治性睾丸切除术时（72%）。不提供睾丸假体植入最常被选择的原因包括担心延迟化疗（41%）、感染（33%）、美容效果受损（17%）和无法获得（17%）。
尽管有证据证实根治性睾丸切除术期间植入睾丸假体的安全性和心理益处，但目前的国际实践表明，只有略多于一半的泌尿外科医生总是为他们的患者提供此项服务。提高临床医生对并发症低风险和患者高满意度的认识可能有助于减少在提供睾丸假体植入方面所感知到的障碍。
