Analysis of the quality of life and patient satisfaction with the results of testicular prosthetics

Abstract

BACKGROUND: Satisfaction with the results is a complex and poorly studied aspect of testicular prosthetics, which currently has no comprehensive consecration in the literature. There are no works that are based on a comprehensive view of the problem, from a subjective analysis of the local physical characteristics of the implant itself and the aesthetic perception of one’s body to assessing the impact of prosthetics on the patient’s sex life and socialization.

AIM: The aim of this study is to evaluate the results of testicular prosthetics using an original questionnaire reflecting satisfaction with the physical characteristics of the implant, sexual behavior characteristics and the socio-psychological status of the patient.

MATERIALS AND METHODS: Questionnaires of 236 patients were analyzed — 112 adults 1 year after prosthetics and 124 adolescents after reaching 18 years of age with a period after surgery from 1 to 8 years. The survey was carried out using an original questionnaire that included 15 questions reflecting various aspects of the patient’s attitude to the results of prosthetics.

RESULTS: Overall satisfaction with prosthetics was more than 90% in both groups, prevailing in patients operated on in adolescence. The greatest satisfaction with prosthetics was noted in patients after testicular torsion and trauma, less satisfaction in patients with cryptorchidism, testicular hypoplasia, and monorchidism. When analyzing the patient’s interest in this procedure depending on the period before prosthetics, it was noted that satisfaction does not tend to decrease over time, up to a 10-year interval between the loss of the gonad and prosthetics. Requirements for the final result of prosthetics tend to increase in more educated patients. The results of the survey demonstrate the greatest demands for prosthetics in patients in the age group of 21–30 years as the most sexually active age category.

CONCLUSIONS: Patient satisfaction with modern implant prosthetics is quite high — at least 90%. However, these values are not maximum and leave room for further optimization of this method, which follows from the lack of a maximum assessment of satisfaction with the results of prosthetics — for all criteria the indicators do not exceed 95%.

Keywords

testicular prosthetics / orchiectomy / quality of life

References

[1] Shchedrov DN. Reproductive health status of patients who underwent testicular torsion in childhood [dissertation]. Yaroslavl, 2019. 307 p. (In Russ.)

[2] Щедров Д.Н. Состояние репродуктивного здоровья пациентов, перенесших перекрут яичка в детском возрасте: дис. … доктора мед. наук. Ярославль, 2019. 307 с.

[3] Clifford TG, Burg ML, Hu B, et al. Satisfaction with testicular prosthesis after radical orchiectomy. Urology. 2018;114:128–132. doi: 10.1016/j.urology.2017.12.006

[4] Clifford T.G., Burg M.L., Hu B., et al. Satisfaction with testicular prosthesis after radical orchiectomy // Urology. 2018. Vol. 114. P. 128–132. doi: 10.1016/j.urology.2017.12.006

[5] Legemate CM, de Rooij FPW, Bouman MB, et al. Surgical outcomes of testicular prostheses implantation in transgender men with a history of prosthesis extrusion or infection. Int J Transgend Health. 2020;22(3):330–336. doi: 10.1080/26895269.2020.1840476

[6] Legemate C.M., de Rooij F.P.W., Bouman M.B., et al. Surgical outcomes of testicular prostheses implantation in transgender men with a history of prosthesis extrusion or infection // Int J Transgend Health. 2020. Vol. 22, N. 3. P. 330–336. doi: 10.1080/26895269.2020.1840476

[7] Ramos SA, Pinheiro AM, Barcelos AP, et al. Satisfaction with testicular prosthesis: a Portuguese questionnaire-based study in testicular cancer survivors. Rev Int Androl. 2022;20(2):110–115. doi: 10.1016/j.androl.2020.10.006

[8] Ramos S.A., Pinheiro A.M., Barcelos A.P., et al. Satisfaction with testicular prosthesis: a Portuguese questionnaire-based study in testicular cancer survivors // Rev Int Androl. 2022. Vol. 20, N. 2. P. 110–115. doi: 10.1016/j.androl.2020.10.006

[9] Chen H-X, Ning Y, Cai Z-K, et al. Safety and effectiveness of testicular prosthesis implantation for testis loss: clinical observation of 18 cases. Zhonghua Nan Ke Xue. 2012;18(4):349–352.

[10] Chen H.-X., Ning Y., Cai Z.- K., et al. Safety and effectiveness of testicular prosthesis implantation for testis loss: clinical observation of 18 cases // Zhonghua Nan Ke Xue. 2012. Vol. 18, N. 4. P. 349–352.

[11] Zilberman D, Winkler H, Kleinmann N. Testicular prosthesis insertion following testicular loss or atrophy during early childhood — technical aspect and evaluation of patient satisfaction. J Pediatr Urol. 2007;3(6):461–465. doi: 10.1016/j.jpurol.2007.05.006

[12] Zilberman D., Winkler H., Kleinmann N. Testicular prosthesis insertion following testicular loss or atrophy during early childhood — technical aspect and evaluation of patient satisfaction // J Pediatr Urol. 2007. Vol. 3, N. 6. P. 461–465. doi: 10.1016/j.jpurol.2007.05.006

[13] Kogan S. The clinical utility of testicular prosthesis placement in children with genital and testicular disorders. Transl Androl Urol. 2014;3(4):391–397. doi: 10.3978/j.issn.2223-4683.2014.12.06

[14] Kogan S. The clinical utility of testicular prosthesis placement in children with genital and testicular disorders // Transl Androl Urol. 2014. Vol. 3, N. 4. P. 391–397. doi: 10.3978/j.issn.2223-4683.2014.12.06

[15] Incrocci L, Bosch JL, Slob AK. Testicular prostheses: body image and sexual functioning. BJU Int. 1999;84(9):1043–1045. doi: 10.1046/j.1464-410x.1999.00347.x

[16] Incrocci L., Bosch J.L., Slob A.K. Testicular prostheses: body image and sexual functioning // BJU Int. 1999. Vol. 84, N. 9. P. 1043–1045. doi: 10.1046/j.1464-410x.1999.00347.x

[17] Skewes J, Chen MY, Forrestal D, et al. 3D printing improved testicular prostheses: using lattice infill structure to modify mechanical properties. Front Surg. 2021;8:626143. doi: 10.3389/fsurg.2021.626143

[18] Skewes J., Chen M.Y., Forrestal D., et al. 3D printing improved testicular prostheses: using lattice infill structure to modify mechanical properties // Front Surg. 2021. Vol. 8. ID 626143. doi: 10.3389/fsurg.2021.626143

[19] Park H-J, Kim D-K, Lee BW, et al. Development of device for patient-specific artificial testicle using 3D printing. Int J Eng Res Technol. 2019;12(12):2863–2866.

[20] Park H.-J., Kim D.-K., Lee B.W., et al. Development of device for patient-specific artificial testicle using 3D printing // Int J Eng Res Technol. 2019. Vol. 12, N. 12. P. 2863–2866.

[21] Araújo AS, Anacleto S, Rodrigues R, et al. Testicular prostheses — impact on quality of life and sexual function. Asian J Androl. 2023;26(2):160–164. doi: 10.4103/aja202325

[22] Araújo A.S., Anacleto S., Rodrigues R., et al. Testicular prostheses — impact on quality of life and sexual function // Asian J Androl. 2023. Vol. 26, N. 2. P. 160–164. doi: 10.4103/aja202325

[23] Shormanov IS, Shchedrov DN. Medical and social rehabilitation following testicular prosthesis in post-orchiectomy patients. Urology reports (St. Petersburg). 2018;8(2):43–52. EDN: XTMHCP doi: 10.17816/uroved8243-5

[24] Шорманов И.С., Щедров Д.Н. Особенности протезирования яичка у пациентов, перенесших орхэктомию в аспекте медико-социальной реабилитации // Урологические ведомости. 2018. Т. 8, № 2. С. 43–52. EDN: XTMHCP doi: 10.17816/uroved8243-52

[25] Catanzariti F, Polito B, Polito M. Testicular prosthesis: Patient satisfaction and sexual dysfunctions in testis cancer survivors. Arch Ital Urol Androl. 2016;88(3):186–188. doi: 10.4081/aiua.2016.3.186

[26] Catanzariti F., Polito B., Polito M. Testicular prosthesis: Patient satisfaction and sexual dysfunctions in testis cancer survivors // Arch Ital Urol Androl. 2016. Vol. 88, N. 3. P. 186–188. doi: 10.4081/aiua.2016.3.186

RIGHTS & PERMISSIONS

Eco-Vector