Some individuals with differences of sex development (DSD) may opt for testicular prosthesis implantation. Little is known on (long-term) surgical outcomes. All testicular prosthesis implantation procedures, performed in individuals with DSD, between 01-1980 and 06-2024 were retrospectively identified from our hospital registry. A retrospective chart study was performed, recording: indication for implantation, medical and surgical history, prosthesis characteristics and intra- and postoperative complications and reoperations. A total of 27 (47 XXY (n = 15), 46 XY (n = 10) and 46 XX (n = 2)) DSD patients were included. The median clinical follow-up was 14.6 (IQR 3.5–27.8) years. Twelve (44.4%) procedures were combined with other concurrent surgical procedures. Short-term complications were rare: in one individual (3.7%), immediate postoperative hemorrhage required a reoperation under general anesthesia. Long-term complications comprised adhesions (n = 1 (3.7%)) and prosthesis replacement due to it being too small. Prosthesis rupture was diagnosed in two patients, after a postoperative time of 10.5 and 26.0 years. These were replaced. At last follow-up, all individuals had prosthesis in situ. To conclude, complications and reoperations are scarce after testicular prosthesis implantation in individuals with DSD. Scrotal augmentation via testicular prosthesis placement is easy to perform and technically highly successful. Furthermore, it can be safely combined with different types of (non-)genital surgical procedures.
- Wouter B. van der Sluis
- Tim C. van de Grift
