Testicular Prosthesis Surgery in Singapore

• Men who have undergone orchiectomy for testicular cancer, torsion, or trauma
• Individuals with congenital absence of one or both testicles
• Patients who have psychologically adjusted to their testicle loss and have realistic expectations
• Those in good general health without active infections or uncontrolled medical conditions
• Men who have completed cancer treatment and received clearance from their oncologist (if applicable)
• Individuals seeking cosmetic restoration for personal or intimate confidence
• Patients who have allowed adequate healing time after initial surgery (typically 3-6 months if not done simultaneously)

• Active infection in the scrotal area or systemic infection
• Unresolved cancer or ongoing cancer treatment (consultation with oncologist required)
• Severe scarring or inadequate scrotal tissue from previous surgery or radiation
• Bleeding disorders or inability to stop anticoagulation medications
• Unrealistic expectations about functional restoration
• Poor surgical candidates due to severe medical conditions
• History of rejection or complications with previous implants

The decision to proceed with testicular prosthesis surgery requires careful evaluation by an experienced urologist who can assess your individual circumstances, medical history, and tissue quality to determine if you’re a suitable candidate for the procedure.

The inguinal approach is the most commonly used technique for testicular prosthesis placement. This method involves making an incision in the groin area, similar to the approach used for hernia repair or the original orchiectomy. Through this incision, the surgeon creates a pocket in the scrotum and carefully positions the implant. This approach provides good surgical visibility and allows for precise placement while minimising the risk of infection since the incision is made away from the scrotal skin.

In selected cases, particularly when placing a prosthesis long after the original surgery, a direct scrotal approach may be used. This involves making an incision directly on the scrotum to create the pocket for the implant. While this approach involves a shorter operative time, it requires careful technique to ensure proper positioning and minimise infection risk. The choice between approaches depends on factors such as previous surgical scars, timing of the procedure, and surgeon preference.

Modern testicular prostheses are manufactured from medical-grade materials designed for long-term biocompatibility. Saline-filled implants consist of a silicone elastomer shell filled with sterile saline solution, while solid silicone implants are made from cohesive silicone gel. Both types are available in various sizes to match the patient’s anatomy. The implants feature a smooth or textured surface designed to minimise movement and maintain proper positioning within the scrotum.

Before your testicular prosthesis surgery, you’ll undergo a comprehensive evaluation including a physical examination and review of your medical history. Blood tests may be ordered to ensure you’re healthy for surgery. You’ll need to stop certain medications, particularly blood thinners, according to your surgeon’s instructions. Antibiotics may be prescribed to start the day before surgery. You’ll be instructed to fast from midnight before your procedure and arrange for someone to drive you home afterwards. Shaving the surgical area may be required, though this is often done in the hospital.

The surgery typically takes 30 to 60 minutes and is performed under general anaesthesia or spinal anaesthesia with sedation. Once you’re comfortable, the surgeon makes the incision (either inguinal or scrotal) and creates a pocket within the scrotum for the implant. The appropriately sized prosthesis is then carefully inserted and positioned to match the remaining testicle or to achieve symmetry if bilateral implants are placed. The surgeon ensures proper positioning and that the implant sits naturally before closing the incision with absorbable sutures. A supportive dressing and scrotal support are applied to minimise swelling and provide comfort.

After surgery, you’ll be monitored in the recovery area as the anaesthesia wears off. Pain medication will be provided to manage any discomfort, which is typically mild to moderate. Ice packs may be applied to reduce swelling. Most patients can go home the same day once they’re fully awake and comfortable. You’ll receive detailed instructions about wound care, medication use, and activity restrictions. A scrotal support or snug-fitting underwear should be worn continuously for the first week to minimise movement and swelling. Warning signs such as excessive bleeding, severe pain, or signs of infection will be explained before discharge.

During the initial recovery period, rest is essential with minimal activity. Keep the surgical site clean and dry according to your surgeon’s instructions. Apply ice packs for 20 minutes at a time to reduce swelling, with a cloth barrier to protect the skin. Take prescribed pain medication as directed and antibiotics if prescribed. Wear supportive underwear or a scrotal support continuously. Avoid heavy lifting, straining, or strenuous activities. Some swelling and bruising are normal, but contact your surgeon if you experience fever, excessive bleeding, or severe pain.

Continue wearing scrotal support and avoid submerging the incision in water (showers are usually permitted after 48 hours). Gradually increase light activities such as walking, which helps prevent blood clots. Attend your follow-up appointment for wound check and to ensure proper implant position. Most patients can return to desk work after 3-5 days but should avoid physical labour. Continue taking any prescribed medications and watch for signs of infection such as increasing redness, warmth, or discharge from the incision site.

Full recovery typically occurs within 4-6 weeks. Most normal activities, including exercise, can be resumed after 2-3 weeks with your surgeon’s approval. Sexual activity can usually be resumed after 4-6 weeks once healing is complete and you’re comfortable. The implant will soften slightly and feel more natural as swelling resolves completely. Annual check-ups are recommended to ensure the implant remains properly positioned and intact. While complications are rare, be aware that implants may need replacement after many years due to wear or changes in scrotal tissue.

The most common side effects after testicular prosthesis surgery include swelling and bruising of the scrotum, which typically resolve within 2-3 weeks. Mild to moderate pain or discomfort is expected but manageable with prescribed pain medication. Some patients experience temporary numbness around the incision site that improves as nerves heal. The implant may feel firm or sit slightly higher initially but usually settles into a more natural position as swelling decreases. Minor asymmetry with the remaining testicle is possible but often not noticeable.

Though uncommon, infection occurs in approximately 2-3% of cases and may require antibiotic treatment or implant removal in severe cases. Haematoma (blood collection) may develop, potentially requiring drainage. Implant extrusion, where the prosthesis erodes through the skin, is rare but may necessitate removal. Some patients experience chronic pain, though this is uncommon with proper surgical technique. Implant rupture or deflation can occur, particularly with saline-filled types, requiring replacement. Capsular contracture, where scar tissue forms around the implant causing firmness or discomfort, may develop over time.

These risks are minimised through proper surgical technique, appropriate patient selection, and adherence to post-operative care instructions. Choosing an experienced urologist familiar with prosthetic implantation reduces the likelihood of complications.