Testicular sparing surgery for small masses.
OBJECTIVE
To determine the proportion of benign testicular lesions among candidates for testicular sparing surgery (TSS) and to assess the safety and efficacy of this procedure.


METHODS
Sixteen patients underwent surgical exploration for testicular tumors with TSS intent in our center. Surgery was performed via an inguinal approach with temporary cord occlusion and frozen section (FS) analysis of the lesions. Benign findings allowed for TSS, whereas cancer prompted total orchiectomy.


RESULTS
The lesions measured 8-25 mm in the largest diameter. Eleven of the 16 lesions were benign (69%) and TSS was accomplished in these cases. Complete concordance was observed between the results of FS and permanent sections. Of the 5 patients with cancer, 3 had pure seminoma, and embryonal carcinoma and teratoma were found in 1 patient, each. Surveillance was applied in 4 of these patients, and chemotherapy was used in the patient with embryonal carcinoma. With an average follow-up duration of 48 months, all are alive and free of disease. All 11 patients in whom TSS was accomplished had an uneventful postoperative course, and with an average follow-up duration of 28 months, 9 have normal scrotal physical examination and ultrasound, whereas 2 patients were lost to follow-up.


CONCLUSIONS
Sixty-nine percent of testicular lesions under 25 mm are benign. TSS is safe and effective in patients with small benign lesions. Cancer is reliably detected by FS, and testicular exploration is not associated with local or distant recurrence in any of our patients.
Shilo
Yaniv
Y
Department of Urology, Assaf Harofeh Medical Center, Zerifin, Israel.
Zisman
Amnon
A
Raz
Orit
O
Lang
Erez
E
Strauss
Simon
S
Sandbank
Judith
J
Segal
Michael
M
Siegel
Yoram I
YI
Leibovici
Dan
D
D000328:Adult; D000368:Aged; D005500:Follow-Up Studies; D005629:Frozen Sections; D006801:Humans; D008297:Male; D008875:Middle Aged; D059351:Organ Sparing Treatments; D011379:Prognosis; D012189:Retrospective Studies; D013736:Testicular Neoplasms / Q000473:pathology* / Q000601:surgery*; D013737:Testis / Q000473:pathology* / Q000601:surgery*; D055815:Young Adult