title: Temporary relocation of testes to the anterior abdominal wall before radiation therapy of the pelvis or perineum.
abstract: Recent advances in the treatment of pelvic malignancies in children has resulted in an increased life expectancy. In the past, treatment of soft tissue sarcomas with simple surgical excision resulted in a recurrence rate of approximately 75%. Combination of chemotherapy, radiotherapy, and surgery have significantly altered the outcome of advanced pelvic soft tissue sarcomas. With the improved survival rate of patients treated with combination therapy, sterility secondary to radiation therapy has become an issue. As little as 600 rads to the gonads may result in sterility later in life. To alleviate this problem, relocating the gonads from the field of radiation has been suggested. In this report, we present a novel approach in which the testes are wrapped in SILASTIC (Dow Corning, Midland, MI) sheaths and are relocated temporarily into the anterior abdominal wall away from the radiation field. This alternative surgical approach should be considered in boys who are afflicted with a pelvic/perineal malignancy requiring radiation therapy.
authors.affiliation: Division of Pediatric Surgery Childrens Hospital Los Angeles and the Keck School of Medicine, University of Southern California, Los Angeles, CA 90027, USA.
authors.forename: Juan M
authors.initials: JM
authors.lastname: Acosta
authors.forename: Greg
authors.initials: G
authors.lastname: Tiao
authors.forename: James E
authors.initials: JE
authors.lastname: Stein
authors.forename: G Hossein
authors.initials: GH
authors.lastname: Mahour
mesh_terms: D000293:Adolescent; D002081:Buttocks; D002648:Child; D004129:Dimethylpolysiloxanes; D006119:Groin; D006801:Humans; D007223:Infant; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control; D011187:Posture; D011481:Protective Clothing; D011832:Radiation Injuries / Q000517:prevention & control*; D011835:Radiation Protection / Q000379:methods*; D011859:Radiography; D018233:Rhabdomyosarcoma, Embryonal / Q000000981:diagnostic imaging / Q000532:radiotherapy*; D012828:Silicones; D012983:Soft Tissue Neoplasms / Q000000981:diagnostic imaging / Q000532:radiotherapy*; D013737:Testis
chemical_list: D004129:Dimethylpolysiloxanes; D012828:Silicones; C013830:baysilon