(144) Contemporary Trends in Testicular Prosthesis Placement: An Analysis Of U.S. Claims Data

Abstract

Abstract Introduction Testicular prosthesis placement (TPP) is a procedure associated with high patient satisfaction that improves body image and quality of life following orchiectomy. However little information exists regarding contemporary TPP as placement for metastatic prostate cancer has fallen out of favor and gender affirming surgery is on the rise. Objective This study sought to describe current trends in TPP in the United States. Methods Using the IBM® MarketScan® Research Databases (DOI 10.57761/ray7-1g16) we performed a retrospective analysis from 2007 to 2021 and identified 1,059 adult men who had undergone placement of a testicular prosthesis based on ICD-9 codes. Results The median age of TPP was 34 (IQR 23-44; range 18-80). At least 433 (35.5%) men were married. A total of 536 (43.8%) men had orchiectomy concurrently at the time of TPP. Just under half of the cases prescribed antibiotics postoperatively (44.9%). The five most common indications at the time of TPP were malignancy (54.7%), gender dysphoria (10.4%), cryptorchidism (9.6%), atrophy/hypofunction (6.6%), and testicular torsion (3.9%). A total of 46 (3.8%) of men underwent subsequent removal of their prosthesis. A diagnosis of gender dysphoria was associated with prosthesis removal (odds ratio (OR) 4.51, 95% CI 2.10-9.86). No significant associations were seen for other indications, Charlson Comorbidity Index scores, post-operative antibiotic use, tobacco use, psychiatric diagnoses, or prior pain diagnoses. Rates of testicular prosthesis placement for a diagnosis of gender dysphoria are rapidly increasing while placement for prostate cancer is increasingly rare. Conclusions Among the studied population the primary indication for testicular prosthesis placement is for testicular cancer, contradicting the findings of earlier series. We also show that TPP for gender dysphoria is increasingly common. Additionally, we report rates of explanation and complications related to prosthesis that are higher than what is described in the literature. Disclosure No.