{"id":976,"date":"2019-03-28T00:14:46","date_gmt":"2019-03-28T00:14:46","guid":{"rendered":"https:\/\/www.newyorkurologyspecialists.com\/mens-health\/?page_id=976"},"modified":"2021-02-28T20:40:57","modified_gmt":"2021-02-28T20:40:57","slug":"surgical-technique","status":"publish","type":"page","link":"https:\/\/www.newyorkurologyspecialists.com\/mens-health\/testicular-implants\/surgical-technique\/","title":{"rendered":"Testicular Implants: Surgical Technique and Technical Considerations"},"content":{"rendered":"\r\n

Surgical Approach to Testicular Implant Surgery: Our Technique<\/strong><\/h1>\r\n\r\n\r\n\r\n

by Alex Shteynshlyuger MD<\/a><\/strong><\/p>\r\n

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If you have any questions, to schedule a consultation<\/a>, please <\/a>contact us<\/a> or call\/text: 1-212-204-6300<\/span><\/a><\/strong>.<\/strong><\/p>\r\n

We have excellent reviews from patients <\/a><\/strong>and their partners.  Information for out-of-state and international patients<\/a>.  Find out our office hours or directions to our office<\/a>. <\/strong><\/span><\/p>\r\n

We offer affordable appointment prices<\/a> with or without insurance.  <\/strong><\/span>Same-day virtual video appointments<\/strong> and in-person appointments<\/strong> are available.<\/span><\/p>\r\n\r\n\r\n

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Dr. Alex Shteynshlyuger is one of the most experienced surgeons performing testicular implant insertion and revision in New York City.<\/p>\r\n\r\n\r\n\r\n

Testicular Prosthesis Insertion: Surgical Considerations<\/strong><\/h2>\r\n\r\n\r\n\r\n

The surgery for placement of a testicular prosthesis (implant)<\/a><\/strong> is fairly simple in experienced hands. There are two common ways to place a testicular implant in the scrotum. The first method is through an incision in the scrotum<\/strong>. The other method is through an incision in the inguinal\/subinguinal or high scrotal region<\/strong>.<\/p>\r\n\r\n\r\n\r\n\r\n\r\n

\"\"Groin versus Scrotal Incision for Testicular Prosthesis Placement<\/strong><\/p>\r\n

At New York Urology Specialists, we prefer to use a subinguinal incision for testicular implant placement<\/strong> in most cases. For patients who are undergoing inguinal orchiectomy (removal of the testicle), simultaneous insertion of the prosthesis is possible through the same incision. For most other patients, a subinguinal incision provides an opportunity for a smaller incision, faster recovery<\/a><\/strong>, and a smaller risk of complications<\/a><\/strong> compared to a scrotal incision.<\/p>\r\n\r\n\r\n\r\n

Because the scrotal incision sits adjacent to the implant itself, wound infection is more likely to spread to the newly-inserted prosthesis, which could lead to wound opening and extrusion of the implant.  In addition, the risk of extrusion is higher when the incision is adjacent to the prosthesis rather than when the incision is made away from the location of the prosthesis.  A subinguinal incision also allows the surgeon more opportunity to expand the scrotal sac.<\/p>\r\n\r\n\r\n\r\n\r\n\r\n

Suture Anchored versus Free Floating Implant<\/strong><\/h2>\r\n\r\n\r\n\r\n

There are two surgical approaches<\/strong> to placing a testicular implant in the scrotum. Traditionally, the implant is sutured (anchored with a stitch)<\/strong> to the scrotal wall so that it does not move. Studies show that while that provides an adequate surgical outcome, the aesthetic outcome tends to be better when the prosthesis is left unanchored or free-floating<\/strong> in the scrotal sac.<\/p>\r\n\r\n\r\n\r\n

If the patient can be relied on to comply with postoperative instructions<\/strong><\/a> for a few months, which include daily pulling of the implant down into the scrotum so that it heals in a good low position<\/strong>, then a more pleasing aesthetic outcome is typically achieved with a non-anchored prosthesis.<\/p>\r\n\r\n\r\n\r\n

We prefer placing an unanchored or free-floating testicular implant, <\/strong>as it usually leads to a better cosmetic appearance and less scar tissue in the scrotum. To prevent the implant from riding up into the groin, we place a few stitches to close off the space leading to the skin opening in the subinguinal or inguinal region.<\/p>\r\n\r\n\r\n\r\n

Disadvantages of Scrotal Sac Incision for Placement of Testicular Implants<\/strong><\/h2>\r\n\r\n\r\n\r\n

The surgical placement of a testicular implant through the scrotal skin<\/strong> is simple, fast, and causes minimal pain to the patient. Unfortunately, in my opinion, it does not lead to optimal outcomes and increases the risks of prosthesis erosion and infection<\/strong><\/a>.<\/p>\r\n\r\n\r\n\r\n

Underdeveloped Scrotum and Size Discrepancy<\/strong><\/h2>\r\n\r\n\r\n\r\n

Testicular implant surgery<\/a> is sometimes more complicated in patients with an underdeveloped scrotum<\/strong> on the side where the testicle is missing. This most commonly occurs when the testicular loss occurred in childhood or early adolescence. As a result of the missing testicle on one side, the testicle on the contralateral side may become larger than normal to compensate for the lost testicle.<\/p>\r\n

The scrotum on the side where the testicle is missing is small and underdeveloped<\/strong>.  There is limited space in which to insert the prosthesis.<\/strong>  Because the size of the scrotum is not the same on the side of the missing testicle, the prosthesis would sit higher than the \u2018normal testicle\u2019 on the other side.  To address this problem, the scrotum needs to be expanded before testicular implant insertion.<\/strong><\/p>\r\n\r\n\r\n\r\n

Fortunately, the scrotum is often fairly \u2018pliable\u2019 and stretchable.  The scrotum can be expanded to some extent during surgery with mechanical stretching. In more severe cases, tissue expanders<\/a> may be used<\/strong> in an effort to stretch the tissue for a few months prior to testicular implant insertion.  Tissue expansion can take a few weeks to a few months to occur but may be beneficial in some men with disproportionately small scrotal volume compared to the ‘normal’ side.  New York Urology Specialists is one of the few practices in the US to offer scrotal tissue expansion.<\/p>\r\n\r\n\r\n\r\n

Ideally, during the surgical procedure, the surgeon selects a prosthesis similar in size to the normal testicle on the other side. When a patient is missing both testes, the decision-making is a little bit more complicated because both sides of the scrotum are underdeveloped.<\/p>\r\n\r\n\r\n\r\n

Age at Implantation<\/strong><\/h2>\r\n\r\n\r\n\r\n

The second variable in testicular implant insertion involves the child’s age<\/strong>. Early prosthesis placement has the advantage of possibly preventing shrinkage of the scrotum over time, which can be a cosmetic concern, especially in adolescent boys.<\/p>\r\n\r\n\r\n\r\n

However, when a prosthesis is placed in children or pre-adolescents, it often necessitates placing a smaller implant because a large implant would be disproportionate to the scrotal size and the child’s anatomy. The problem arises when the child grows up, and the prosthesis becomes small relative to body size<\/strong>. Many patients desire testicular implant replacement to a larger-sized prosthesis<\/a> commensurate with the size of adult anatomy.  Upsizing the testicular implant is a fairly simple procedure for most patients.  We do this routinely at New York Urology Specialists.<\/p>\r\n\r\n\r\n\r\n

Testicular Implant Surgery at New York Urology Specialists – What to Expect<\/h2>\r\n\r\n\r\n\r\n

The testicular prosthesis does not affect the ability to obtain erections.  It does not affect the ability to orgasm or ejaculate.  <\/p>\r\n\r\n\r\n\r\n

We offer affordable, highest-quality urology care with or without insurance.  <\/strong> Find out our office hours or directions to our office<\/a>. We offer weekday, weekend, and evening office hours.<\/p>\r\n\r\n\r\n\r\n

Testicular Prosthesis – Excellence in Care<\/h2>\r\n

Did you know?<\/strong><\/span> Dr. Shteynshlyuger<\/a> <\/strong>has performed over 1,000 penile, scrotal, testicular, kidney, bladder, and prostate surgeries,<\/strong> including testicular implants, hydrocelectomy, varicocelectomy, scrotoplasty, circumcisions, circumcision revisions, frenuloplasty, penile implants, Urolift, prostate enucleation, correction of Peyronie’s disease, and congenital penile curvature.  He performs 150-200 penile surgeries a year.<\/p>\r\n

Where to Get Testicular Prosthesis for Men with a Missing Testicle in NYC?<\/h2>\r\n

At New York Urology Specialists, we offer same-day treatment for men<\/strong>.  Same-day virtual video appointments<\/strong> and in-person<\/strong> appointments are available.<\/p>\r\n

Call\/text today: 1-212-204-6300<\/span><\/a> <\/span><\/strong>or <\/span>make an appointment<\/span><\/a> online.  <\/span><\/span><\/strong><\/p>\r\n

We perform testicular implants<\/a><\/strong>, scrotal surgery<\/a><\/strong>, penile procedures<\/a><\/strong>, varicocele<\/a> <\/strong>and hydrocele repair<\/a><\/strong>, and cosmetic circumcision.<\/a>  <\/strong>We offer treatment for phimosis, balanitis, missing testis, low testosterone, penile irritation, and redness. We treat sexual and erection problems<\/a><\/strong> and offer comprehensive STD testing<\/a><\/strong> for infections. We offer confidential<\/strong> appointments.<\/p>\r\n

Our appointment costs<\/a> are affordable with or without insurance<\/strong>.  We offer free insurance verification<\/strong>.<\/p>\r\n

We perform cystoscopy, penile and testicular ultrasound in our office.  We offer testosterone replacement therapy<\/a>, vasectomy<\/a>, Urolift procedure<\/a><\/strong>, Rezum water-vapor procedure<\/a><\/strong> in our office.   We treat urinary<\/strong> and erection problems<\/a><\/strong>. We offer confidential<\/strong> appointments.<\/p>\r\n

Cost of Men’s Health Treatment without Insurance<\/h2>\r\n

At New York Urology Specialists, we offer affordable treatment for men<\/strong><\/a>. Our prices are low<\/strong> for patients without insurance<\/strong> and for those who have high insurance copays, high deductibles, or insurance plans that do not cover treatment costs. <\/p>\r\n

At New York Urology Specialists, we offer flat-fee, ‘all-costs-included’ procedures such as scrotal and testicular surgery, circumcision, no-scalpel vasectomy, testicular implant, vasectomy reversal, hydrocelectomy, varicocelectomy, and many more<\/strong>.  The procedures are performed in our office under local anesthesia or sedation. Men from other states can save thousands of dollars over local hospital fees by coming to New York Urology Specialists for treatment.  Please contact us for current prices and discounts for patients without insurance or with high insurance deductibles<\/strong>.<\/p>\r\n

Cost of Treatment and Insurance<\/h2>\r\n

\"InexpensiveAt New York Urology Specialists, we offer affordable treatment for men<\/strong><\/a>. Our prices are low<\/strong> for patients without insurance<\/strong><\/span> and for those who have high insurance copays, high deductibles, or insurance plans that do not cover treatment costs. <\/p>\r\n

We accept many health insurance plans.<\/strong>  We would be happy to verify your eligibility and benefits<\/strong> and provide you with detailed information on your health plan’s coverage.  Financing options<\/a> <\/strong>and credit options are available to help you pay for medical care.<\/p>\r\n

Why Choose New York Urology Specialists for Testicular Implants and Treatment of Testicular Problems?<\/h2>\r\n