Prosthetic Testicles: What Are They and Who Gets Them?
As the name suggests, prosthetic testicles are artificial replacements for testicles (one or both). Also known as a testis or testicular prosthesis, prosthetic testicles are typically used to take the place of a testicle lost to testicular cancer, trauma or congenital conditions.
Prosthetic testicles are often sought by patients whose testicles failed to descend into the scrotum at birth or for a number of other reasons, said Paul Turek, M.D., a California-based urologist and a medical advisor for Progyny, a provider of employee fertility benefits.
"[Testicle implants] are also highly desired in patients in whom a testicle twisted or sustained trauma and was removed as an adolescent or in adults with testicular cancer in which the testicle was removed to treat the malignancy," Turek said. "An emerging population in need of testicular implants are trans males undergoing gender-affirming surgery."
What are prosthetic testicles?
The testicular implants available in the United States are made of silicone and filled with saline, said Adam Baumgarten, M.D., a urologist at the University of Alabama Birmingham.
"The shape, weight and texture are designed to mimic the natural testicle," Baumgarten said.
When implanted correctly, prosthetic testicles are safe and virtually indistinguishable from the real thing.
"However, they are entirely nonfunctional in terms of sperm and hormone production," Turek said.
The history of prosthetic testicles
They may seem like a futuristic innovation, but prosthetic testicles have been around for more than 70 years. Versions made of glass, plastic and rubber have been used since 1941.
The first silicone testicular implant was developed in 1973. These silicone gel-filled testicular implants were discontinued in 1995 due to growing concerns about connective tissue and autoimmune disorders associated with silicone breast implants.
In 2004, Turek led a team of researchers at the University of California, San Francisco in testing a newly designed prosthetic testicle made with a silicone casing filled with saline. At the end of the five-year study, the team concluded that the new design was safe and well tolerated.
"There was a less than 5 percent complication rate of infection, bleeding, device migration or extrusion," Turek said. "There were no device failures, so [saline-filled testicle prosthetics] should be good to go for life once implanted."
These improved testicle prostheses were approved by the U.S. Food and Drug Administration (FDA) for clinical use in 2002. The saline-filled model remains the only type of prosthetic testicle currently available in the U.S.
What is the process for implanting testicles?
Implanting prosthetic testicles is performed during an outpatient surgery that requires minimal recovery, Baumgarten said.
"The implant can be placed at the time of orchiectomy, [a surgery to remove the testicles] or in a second setting," Baumgarten said. "It is typically placed through a small incision in the groin."
The incision is usually made where it can be "hidden," either below the penis or along a scrotal fold, Turek said. The entire procedure is performed under local or sedative anesthesia and lasts between 35 and 45 minutes.
"Recovery is quick, requiring only one or two pain pills, and a return to full activity is possible in three to four days," Turek said.
Are there potential prosthetic testicle problems?
The procedure for installing testicular prostheses is safe, as are the implants themselves, according to Baumgarten. The possibility of experiencing prosthetic testicle problems is low.
"Risks include a very small risk of prosthetic infection and a suboptimal appearance," Baumgarten said.
Should I get a prosthetic testicle?
If you feel unhappy or self-conscious about an absent testicle or are worried about an upcoming procedure that will require testicle removal, a testicular prosthesis is a consideration.
Prosthetic testicles carry the psychological benefit of feeling and appearing like natural testicles and the cosmetic benefit of a naturally appearing scrotum, Baumgarten said.
Many patients see an improved quality of life after receiving a testis prosthesis, Turek said.
"Similar to breast implants being placed in cases of breast cancer, patients feel 'normal' again and do not think about the issue after organ symmetry is achieved," he said.