Introduction: Radical orchiectomy is the standard of care in patients with testicular cancer (TC). The placement of testicular prosthesis (TP) can reduce the psychosocial burden, restore self-image and improve the quality of life of patients who require orchiectomy. There is limited data on patient attitudes and counseling about TP. The objective of this study was to characterize the experiences of patients in the presence or absence of TP, the justification for seeking/refusing TP, and the related levels of sexual satisfaction or dysfunction. This information can support urologists in advising patients in their decision to receive or decline a TP placement. Methods: Fifty-six patients undergoing radical orchiectomy for TC were evaluated, 26 of them underwent TP placement in a period between 2004 and 2020. A survey was carried out applying the IIEF-5 score (International Index of Erectile Function) and MSH (Male Sexual Health) questionnaires evaluating Domains Assessors of Sexual Response (DERS) and Descriptives of Sexual Activity (DDAS), then the variables associated with placement and the items of the questionnaires were compared between both groups Results: Median age at TP placement was 33 years (20-45). Two patients reported complications and underwent explantation (7.7%). 54 (94.6%) patients mentioned that they had been offered a TP prior to orchiectomy and all of them felt that being offered an implant was important. Overall, 24 (92%) patients would have the TP implanted again and found the TP to be comfortable. Of the patients without TP, the most common reason for rejection was related to cost in 19 (63.3%) cases. Subsequently, prosthesis users were compared with non- users. A higher rate of patients with a stable sexual partner was found in the group of patients without TP (80 vs 46.2%, p = 0.008). No differences were found in the score on the IIEF-5 score between both groups (23.1 vs 23, P=0.843). In terms of the global score of the MSH DERS not significant differences were found (97.5 vs 69.7, P= 0.3), while in the global MSH DAS score a significantly higher score was found in patients without TP (9.7 vs. 8.6, P<0.001). Conclusions: When comparing patients with testicular prostheses against patients without testicular prostheses, there are no differences in the rate of sexual dysfunction (IIEF5 and MSH DERS score), however patients without TP reported higher scores regarding interest in sexual activity (MSH DAS), interestingly this difference persists when selecting cases with a stable sexual partner. SOURCE OF Funding: None
