[Conservative surgery for testicular tumours].
The management of testicular tumours is based on inguinal orchidectomy, but conservative surgery is possible in some situations. The indication for conservative surgery is based on clinical assessment, precise analysis of good quality ultrasound images and testicular marker assays. It must be performed according to a strict operative protocol. Conservative surgery may be indicated in the case of teratoma in prepubescent boys, suspicion of epidermal cyst or Leydig cell tumour in adults. Finally, the presence of a germline tumour in a patient with a solitary testis can also be an indication for this type of procedure by observing particularly rigorous imperatives: very motivated patient, absence of hypogonadism, remaining parenchyma representing more than 25% of the initial parenchyma, systematic screening for and treatment of an associated carcinoma in situ by radiotherapy or radical surgery, rigorous and prolonged subsequent surveillance. Only strict compliance with these rules in a very well informed and compliant patient can allow partial orchidectomy to be performed in complete safety, allowing maintenance of endogenous testicular activity.
Mottet
Nicolas
N
Service d'Urologie, Clinique Mutualiste, Saint-Etienne, France. nmottet@mutualite-loire.com
Petit
Michel
M
D006801:Humans; D008297:Male; D013514:Surgical Procedures, Operative / Q000379:methods; D013736:Testicular Neoplasms / Q000601:surgery*