Trends in the use of testicular prostheses in Germany: a total population analysis from 2006-2021

Cem Aksoy; Philipp Reimold; Philipp Karschuck; Christer Groeben; Rainer Koch; Nicole Eisenmenger; Smita Thoduka; Aristeidis Zacharis; Hans Schmelz; Johannes Huber; Luka Flegar

doi:10.1111/andr.13598

Trends in the use of testicular prostheses in Germany: a total population analysis from 2006-2021

Andrology. 2024 Jan 16. doi: 10.1111/andr.13598. Online ahead of print.

Affiliations

¹ Department of Urology, Philipps-University Marburg, Marburg, Germany.
² Reimbursement Institute, Hürth, Germany.
³ Department of Nuclear Medicine, Philipps-University Marburg, Marburg, Germany.
⁴ Department of Urology, German Federal Armed Forces Hospital Koblenz, Koblenz, Germany.

PMID: 38228573
DOI: 10.1111/andr.13598

Abstract

Introduction: Testicular tumors are the most common malignancies in young adults and their incidence is growing. The implantation of a testicular prosthesis, for example, during orchiectomy is a standard procedure but its frequency in Germany is unknown. This study aims to analyze trends of testicular prosthesis implantation in recent years in Germany.

Material and methods: The nationwide German hospital billing database and the German hospital quality reports from 2006 to 2021 were studied.

Results: A total of 12,753 surgical procedures with implantation of testicular prosthesis and 1,244 procedures with testicular prosthesis explantation were included. Testicular prosthesis implantation increased in total from 699 cases in 2006 to 870 cases in 2020 (+11.4 cases/year; p < 0.001). The share of implantation of testicular prosthesis due to testicular tumor decreased from 72.6% in 2006 to 67.5% in 2020 (p < 0.001). The share of implantation due to gender affirming surgery increased from 6.8% in 2006 to 23.3% in 2020 (p < 0.001). The share of implantation due to testicular atrophy decreased from 11.4% in 2006 to 3.4% in 2020 (p < 0.001). Simultaneous implantation of testicular prosthesis during orchiectomy for testicular cancer increased from 7.8% in 2006 to 11.4% in 2020 (p < 0.001). In 2006, 146 hospitals (85%) performed < 5 testicular prosthesis implantation, while 20 hospitals (12%) performed 5-15 implantation procedures and 6 hospitals (3%) performed > 15 testicular implantation surgeries. In 2021, 115 hospitals (72%) performed < 5 testicular prosthesis implantation, while 39 hospitals (25%) performed 5-15 implantation procedures and 5 hospitals (3%) performed > 15 testicular implantation surgeries.

Conclusion: This study shows that implantation of testicular prostheses is steadily increasing. Explantation rates are low. Besides testicular cancer transgender surgeries were the main driver for increasing case numbers in recent years.

Keywords: health services research; implants; population-based analysis; prostheses; testicular cancer.