Testicular cancer (testicular tumour)

Although testicular cancer is a relatively rare malignant disease overall, it is the most common tumour in men aged 20 to 44. Testicular cancer can also occur in later years, but becomes increasingly rare.

There is probably already a certain tendency for certain cells in the testicle to degenerate at birth. Unlike lung cancer, for example, the development of which is promoted by smoking, there are hardly any factors that you can influence yourself in testicular cancer. The greatest risk factor for the development of a testicular tumour is the presence of undescended testicles in childhood. Early surgery can reduce this risk.

There is no screening examination for testicular cancer. However, patients usually feel a testicular tumour themselves, as abnormalities in the testicle are easy to notice. During the examination, the testicles should be palpated individually between the thumb and index finger. The soft structures that sit on the back of the testicles on both sides are the epididymides. They serve to store the seminal fluid. You should now pay attention to whether any hardening can be felt anywhere. The earlier testicular cancer is detected, the better the chances of a cure, which is why regular self-examination is recommended.

As with any cancer, a testicular tumour can be threatening. Although surgery and often chemotherapy are usually necessary, if treated in good time, the chances of a cure are as good as for hardly any other type of cancer.

The most reliable way to find out whether you have testicular cancer is palpation. The urologist also carries out an ultrasound examination, in which tumours can be assessed very well. Certain values in the blood, the so-called tumour markers, may also be elevated. However, these are less important for the diagnosis than for the choice of treatment method and for later monitoring of the course of the disease

Although no effects on sexuality and potency are to be expected if the other testicle is healthy, fertility may be impaired and may worsen further if chemotherapy or radiotherapy is required. For this reason, men who wish to have children are advised to have sperm cells frozen before the operation (cryopreservation).

An operation must be performed whenever a testicular tumour is suspected.

If a testicular tumour is suspected, surgery should be performed promptly. For this purpose, the affected testicle with its spermatic cord is pulled upwards out of the scrotum via an inguinal incision. If there are still doubts about malignancy, a sample is taken during the operation and the tissue is examined microscopically. If the presence of a tumour is confirmed, the testicle is removed.

An inpatient stay of approx. 2–3 days is recommended. You should take it easy physically at first. The histological findings provide information about the type of tumour. Computed tomography/magnetic resonance imaging and blood tests show whether a tumour has already spread. Taking all the findings into account, a decision is then made as to whether further treatment is necessary. Chemotherapy is often recommended; in special cases, radiotherapy may also be useful. In any case, regular check-ups are necessary for at least 5 years.

As with any operation, there are general risks such as bleeding, inflammation and impaired wound healing. There is a minimal risk to the healthy testicle, from which a sample is also taken via a small incision in the scrotum to rule out a tumour. If the healthy testicle is not affected, no effects on sexuality and potency are to be expected. If desired, a testicular prosthesis can be inserted during the procedure for cosmetic purposes. All possible risks of the surgical procedure are discussed in a detailed consultation before the operation.

No. A testicular prosthesis is not medically necessary. It is used exclusively for cosmetic reasons and is an individual decision.

The implantation is usually carried out separately from the removal of the testicle, once the wound has healed. This reduces the risk of impaired wound healing and at the same time provides better local surgical conditions when implanting the prosthesis.

A pocket is created via a small incision in the scrotum, into which the prosthesis is inserted. The procedure is straightforward and is usually performed under local anaesthesia. A barely visible suture remains, which is made with self-dissolving threads.

No. The testicular prosthesis has no influence on sexuality, erectile function or hormone production.

Cosmetic reasons are often the main focus. For many patients, their personal body image and self-esteem also play a role, as a missing testicle can impair self-esteem.