Patient Decision-Making and Predictors of Genital Satisfaction Associated with Testicular Prostheses after Radical Orchiectomy: a Questionnaire-Based Study of Men with Germ Cell Tumors of the Testicle

To better understand patient decision-making and genital satisfaction associated with post-orchiectomy testicular prosthesis implantation in patients with germ cell tumors of the testicle.

An electronic survey to assess testicular prosthesis decision-making and genital satisfaction was distributed to patients via an institutional database (n=70) and social media outlets (n=167). Statistical analyses were performed using chi-square tests for categorical variables, Wilcoxon-Mann-Whitney tests for continuous variables, and multivariate regression analyses to identify independent predictors of receiving a prosthesis, genital satisfaction, and prosthesis satisfaction.

24.9% of respondents elected to receive a testicular prosthesis, but 42% of men without a prosthesis reported never being offered one. Identifying as a heterosexual man (2.86) and receiving a testicular prosthesis (OR = 3.29) were both positive predictors of overall genital satisfaction. Having the orchiectomy performed at an academic institution (OR = 2.87) was a positive predictor of testicular prosthesis placement. 89.8% of testicular prosthesis recipients were satisfied with the look of their prosthetic, but only 59.3% of respondents were satisfied with prosthetic feel.

There are high levels of genital satisfaction in those who elect to receive a testicular prosthesis post-orchiectomy. Associations between TP placement, genital satisfaction, and sexuality merit further investigation. Our results also indicate that patients who pursue an orchiectomy at an academic institution are more likely to receive a TP. The use of social media to recruit study participants in urology should be explored further.

Urology. 2018 Oct 28 [Epub ahead of print]

Paige E Nichols, Kelly T Harris, Aaron Brant, Madeleine G Manka, Nora Haney, Michael H Johnson, Amin Herati, Mohamed E Allaf, Phillip M Pierorazio

James Buchanan Brady Urological Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Urology, Mayo Clinic, Rochester, MN USA. Electronic address: ., James Buchanan Brady Urological Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA. Electronic address: ., James Buchanan Brady Urological Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA. Electronic address: ., James Buchanan Brady Urological Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Urology, Mayo Clinic, Rochester, MN USA. Electronic address: ., James Buchanan Brady Urological Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA. Electronic address: ., James Buchanan Brady Urological Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA. Electronic address: ., James Buchanan Brady Urological Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA. Electronic address: ., James Buchanan Brady Urological Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA. Electronic address: ., James Buchanan Brady Urological Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA. Electronic address: .