Oncological principles
If a tumor is suspected (based on ultrasound and tumor markers), the testicle is never operated on through the scrotum - only through the inguinal approach with initial clamping and intersection of the spermatic cord at the internal inguinal ring, so as not to spread the tumor cells. The removed specimen is examined histologically (seminoma, non-seminoma tumors), the stage is determined using MSCT and markers, after which the urologist prescribes observation, chemotherapy, radiation therapy or retroperitoneal lymphadenectomy. Sperm cryopreservation is offered before the operation, and a prosthesis can be installed during the same operation. Testicular cancer is curable in more than 95% of cases if detected early.
Indications
- testicular tumor - orchofuniculectomy using inguinal access (the first and mandatory stage of treatment);
- testicular necrosis after torsion or injury;
- purulent orchiepididymitis with abscess formation, testicular tuberculosis;
- atrophied testicle, causing pain;
- hormonal therapy for prostate cancer (bilateral orchiectomy);
- cryptorchidism in adults when reduction is impossible.
Consequences and prosthetics
One healthy testicle completely ensures hormonal and reproductive function. For bilateral orchiectomy, testosterone replacement therapy is prescribed (except in cases of prostate cancer). The cosmetic defect is eliminated with a silicone prosthesis, which can be installed immediately or later. Cryopreservation of sperm is recommended before tumor surgery.
