Outcomes of testes-sparing surgery for the treatment of testicular masses: a multi-centre study
BAUS ePoster online library. Viney R. Jun 27, 2018; 211374; P9-2
Richard Viney
Richard Viney
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Abstract
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Introduction: Treatment of testicular masses by inguinal orchidectomy (IO) can have psychological and functional morbidity. This study evaluated the outcomes of testes-sparing surgery (TSS) in the treatment of testicular masses.

Methods: Between 2007 and 2017, 90 cases of TSS were performed with Frozen section analysis (FSA) in 85 men. Patients with testicular cancer, were followed-up with post-operative ultrasound (US). Data were retrospectively analysed from 3 tertiary centres.

Results: Mean age was 34 years (range 17-76). Of the 90 specimens from TSS, 54 were benign and 36 were malignant on FSA. Mean tumour size on US was 9.13mm (1.9-33.0) for benign lesions and 13.2mm (3.7-44.0) for malignant lesions. 47 (87.0%) of the benign lesions, were managed with TSS only, and 7 (13.0%) underwent delayed IO. Of the 36 malignancies, 17 (47.2%) were managed with TSS only, in patients with a solitary testis, bilateral tumours or those refusing IO. 19 (52.8%) malignancies were managed with an additional IO. There was recurrence of 4 (23.5%) malignancies managed by TSS alone. Mean time to recurrence was 31 months (range 2-72 months). All recurrences were safely managed by further surgery. Overall, the testis-sparing rate was 87% for benign pathologies and 38.9% for malignancies.

Conclusions: TSS is an effective treatment option for benign lesions. It may also be offered to manage testicular cancers in selected cases; however, a vigorous post-operative US programme must be followed due to the relatively high rates of recurrence.
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