15993 Testicular Prosthesis

Overview

A testicular prosthesis is an artificial testicle. It is a small, soft, oval-shaped implant, usually made of silicone, that is put inside the scrotum (the pouch of skin that holds the testicles) during a short operation. It is designed to look and feel similar to a natural testicle. People have one when a testicle is missing — for example after surgery to remove it, because it never developed, or after an injury — so the scrotum looks and feels more as expected. A prosthesis is a personal choice, not a medical necessity, and it does not make hormones or sperm.

Yes, it is a fairly common and well-established operation. It has been done for many decades, and many men and boys around the world have an implant. Even so, it is not something people often talk about, so you may not realise how many others have one.

It is mostly for men and boys who have lost a testicle or were born with one missing. Common situations include surgery to remove a testicle because of testicular cancer, a twisted testicle (torsion) that could not be saved, an injury, an undescended testicle that had to be removed, an infection that damaged a testicle, or a condition where a testicle never formed. Some adults also ask for an implant purely for appearance or body confidence after such surgery.

Symptoms

Common symptoms

• A prosthesis is not an illness, so it has no 'symptoms' of its own. Instead, people usually think about one because one side of the scrotum looks or feels empty.
• Feeling self-conscious in changing rooms, sportswear, or intimate situations.
• A noticeable difference in size, shape, or weight of the scrotum after surgery.
• Clothing, swimwear, or underwear fitting differently on one side.
• Emotional discomfort, low confidence, or feeling that the body does not look 'right'.

Symptoms in children

• A parent or carer notices that one side of a boy's scrotum looks empty or smaller than the other.
• A boy may mention that he looks different from friends, especially during pre-teen and teenage years.
• A boy born without one or both testicles (a condition called anorchia) may be offered an implant, sometimes in stages as he grows.
• Some boys feel worried or embarrassed about their body, and may avoid sports, swimming, or changing in front of others.

Symptoms in older adults

• Body image concerns after testicle removal, even many years later.
• Discomfort or unevenness under clothing that affects confidence.
• Questions about whether an implant is safe alongside other health conditions or medicines.
• Interest in a replacement implant if an older one has worn, moved, or become uncomfortable.

Causes

Main causes

• Surgery to remove a testicle (called an orchiectomy), most often as part of testicular cancer treatment.
• A twisted testicle (testicular torsion) that could not be saved.
• Physical injury or trauma to the testicle.
• An undescended testicle that was removed because it could not be brought down safely.
• A testicle that never developed or is missing from birth (anorchia), or differences in how the sex organs developed.
• Damage from a severe infection, or removal for other medical reasons.

Risk factors

• These are not risks of needing an implant, but things that can affect how well implant surgery goes: smoking, which slows wound healing.
• Diabetes or other conditions that affect healing or increase infection risk.
• Previous surgery or scarring in the scrotum.
• A weakened immune system or current infection.
• Being very overweight, which can make wound care and healing harder.
• In children, growth — a small implant may need replacing with a larger one later.

When to see a doctor

See a doctor urgently if:

• Fever, spreading redness, pus, or worsening pain after implant surgery.
• Bleeding or a wound that is opening.
• The implant feels hard, has shifted a lot, or seems to be coming through the skin.
• Sudden severe pain or a new lump in either testicle.

Book a routine appointment if:

• You are thinking about an implant and want to talk through the pros and cons.
• You had an implant some time ago and it feels uncomfortable, looks different, or you would like it replaced.
• You feel low, anxious, or distressed about your body after testicle surgery.
• Your child has one testicle missing or looks different, and you would like advice.
• You have questions about fertility, hormones, or how an implant affects either.

Diagnosis

A testicular prosthesis is not a condition that gets diagnosed — it is an operation you choose after talking with a doctor, usually a urologist (a specialist in urinary and male reproductive health) or a children's surgeon. The doctor will ask about your health, your reasons, and your expectations, and will examine the scrotum. They will explain the options, including doing nothing, using an external prosthesis worn inside underwear or swimwear, or having an implant. If you decide to go ahead, you will usually have routine checks before surgery.

Tests that may be done

• A conversation about your medical history, medicines, and previous surgery.
• A physical examination of the scrotum and groin.
• An ultrasound scan, if anything about the remaining testicle or scrotum needs checking.
• Routine blood tests and a general health check before an anaesthetic.
• For children, an assessment of growth and development to plan the right implant size and timing.

What to expect at your appointment

You will normally have a pre-operative appointment where you can ask anything — about size, feel, scarring, sex, sport, and whether the implant needs replacing later. You will be asked to sign a consent form once you feel fully informed. If you are unsure, it is fine to take more time or ask for a second conversation.

Treatment

There are three main paths, and all are reasonable: leave things as they are; use a soft external prosthesis that sits inside close-fitting underwear or swimwear; or have a surgical implant. The operation itself usually takes less than an hour, is done under a general anaesthetic, and is often a day case, meaning you go home the same day. The surgeon makes a small cut, creates a pocket inside the scrotum, places the implant, and closes the wound with stitches that usually dissolve.

Self-care at home

• Follow your team's instructions about wound care, bathing, and when to change any dressing.
• Wear supportive underwear (such as close-fitting briefs) for the first couple of weeks for comfort.
• Take it easy for a few days; most people need about one to two weeks off work, depending on their job.
• Avoid heavy lifting, cycling, and strenuous sport for the time your team advises — often around four to six weeks.
• Use simple pain relief only as advised by your own clinical team, and ask a pharmacist if you are unsure what is suitable for you.
• Check the wound daily for redness, swelling, or discharge, and keep follow-up appointments.
• Return to sexual activity when you feel comfortable and your team says it is safe.

Medical treatments

There is no medicine that replaces a missing testicle; the choice is between no implant, an external prosthesis, or surgery. If you have lost both testicles, you will need hormone replacement treatment prescribed and monitored by a specialist, because your body can no longer make testosterone. If you have one healthy testicle, it usually makes enough hormone on its own, and your doctor may still check your hormone levels. Fertility is a separate question — an implant does not affect fertility either way — so it is worth asking about sperm banking before any surgery that removes a testicle.

When is surgery considered?

Surgery is considered when you want an implant and your health is suitable. Timing is flexible. After testicular cancer surgery, some people wait several months to a year before deciding, and that is fine. In children, surgeons often wait until a boy is old enough to be involved in the decision, and may plan to swap to a larger implant as he grows. Surgery may be delayed if there is an active infection or if healing from earlier treatment is not complete.

Living with this condition

Most people get used to an implant within a few weeks and stop thinking about it. It should feel soft and move a little within the scrotum, much like a natural testicle. It will not feel exactly the same as before, and that is normal. Over time, an implant can wear, harden, or shift slightly; if that happens, it can usually be replaced with a straightforward operation.

Lifestyle tips

• Once healed, you can swim, cycle, play sport, and wear whatever you like.
• There is no need to avoid tight clothing long term — wear what feels comfortable.
• If you play contact sport, mention it to your surgeon so they can advise on timing and protection.
• An implant does not set off metal detectors and does not usually need any special care.
• Tell any doctor or nurse treating you that you have an implant, especially before scans or surgery in that area.

Diet and exercise

There is no special diet for an implant. Eating well and staying active generally help healing and wellbeing. In the first weeks after surgery, avoid heavy lifting and vigorous exercise, then build back up gradually. Gentle walking is usually encouraged early on to help circulation. If you are having cancer treatment, your team can give advice tailored to you.

Mental health and emotional wellbeing

Losing a testicle can affect how you feel about your body, your confidence, and your sense of yourself as a man. These feelings are common and understandable. Some people feel better after an implant; others find the implant is not the whole answer and benefit from talking to someone. Anxiety, low mood, or difficulties with intimacy are real and treatable — please tell your doctor, and consider counselling or a support group. If you ever have thoughts of harming yourself, contact your local emergency number or a crisis line straight away.

Prevention

A missing testicle usually cannot be prevented, so neither can the need for a prosthesis. What you can control is the decision itself: get clear information, take your time, and choose what feels right for you. If you are having surgery that will remove a testicle, ask your surgeon about the option of an implant at the same time or later.

Vaccines

Routine childhood vaccination, including protection against mumps, helps prevent mumps-related testicular inflammation, which is one uncommon cause of testicle damage. Ask your doctor or pharmacist whether you or your child are up to date.

Screening programmes

There is no screening programme for needing an implant. Being familiar with how your testicles normally look and feel is still worthwhile, and any new lump, swelling, or change should be checked by a doctor.

Complications

If left untreated

• A missing testicle is not dangerous in itself if the other one is healthy — but the reason it was removed (such as cancer) needs ongoing follow-up.
• Some people feel self-conscious or low about their appearance, which can affect confidence, relationships, and intimacy.
• If you have lost both testicles and do not take hormone replacement, you may notice tiredness, low mood, low sex drive, and thinning bones.
• Fertility may be reduced depending on your remaining testicle and any other treatment you had.

Long-term outlook

Most people who choose an implant are pleased with the result, and the operation has an excellent safety record. It is also completely fine to decide against one. Mild discomfort and swelling settle within a few weeks for most people. Complications are uncommon and usually treatable, and an implant can be replaced or removed if needed. Whatever you decide, your health and how you feel about yourself both matter, and support is available.

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