Long-term follow up with sparing surgery for testicular diseases: A safe choice in benign testicular lesions

Abstract

ObjectiveWe performed a long-term evaluation of testicular conservative surgical treatment of benign conditions. Material and methodsBetween January 2001 and January 2005, a single center perspective clinical study was performed at our Academic Department of Urology. Case files of all patients diagnosed with small testicular mass (less than 1.5cm) and treated with conservative surgery were examined. Patients underwent physical examination, hormone and tumor marker assays, scrotal and abdominal ultrasound, chest X-ray and endocrinological examination. Should a benign disease or a selected malignant condition (Leydig cell tumor) be diagnosed during the frozen section analysis, testicular sparing surgery was performed. Each patient presenting a malignant condition underwent a strict oncological follow up according to the EAU Guidelines. ResultsFrom January 2001 to January 2005, 80 patients with small testicular mass underwent conservative surgery. Patient mean age was 40.9 years. Mean follow up was 95.78 months. Patients presented either with a palpable testicular nodule (77.5%) or a nodule diagnosed by ultrasound (22.5%). Diagnosis after frozen section examination was Leydig cell tumor in 20 of 80 cases. Mean histological size of the nodule was 0.93cm. Tumor markers were normal before and after surgery. Follow up was conducted for all malignant patients following EAU Guidelines. No local recurrence or metastasis were observed. 100% of patients are still alive. ConclusionsTesticular Sparing Surgery is feasible in all benign cases. Leydig cell tumors present a favorable long-term follow up when diagnosed early. Conservative surgery proved to be the safer choice.