TY  - EJOU
AU  - Guadagni, Liliana 
AU  - Falcone, Marco 
AU  - Cirigliano, Lorenzo 
AU  - Ferro, Ilaria 
AU  - Preto, Mirko 
AU  - Plamadeala, Natalia 
AU  - Scavone, Martina 
AU  - Zupo, Emanuele 
AU  - Gontero, Paolo 

TI  - Testicular prosthesis complications and satisfaction rates after gender affirming scrotoplasty
T2  - Canadian Journal of Urology

PY  - 
VL  - 
IS  - 
SN  - 1488-5581

AB  -  <b>Background:</b> Testicular prosthesis implantation (TPI) is frequently performed as part of masculinizing genital gender-affirming surgery (GGAS), but complication and satisfaction data for assigned female at birth (AFAB) men remain limited. We report a single-centre experience assessing postoperative complications, explantation-free survival (EFS) and patient-reported satisfaction. <b>Methods:</b> We conducted a retrospective cohort study including all patients who underwent unilateral or bilateral transmasculine TPI (TM-TPI) from May 2007 to April 2025. Primary outcomes were postoperative complications (e.g., surgical-site infection, contamination, hematoma, migration, pain, extrusion) and EFS rate. Satisfaction was measured at 12 months using the 13-item Transmasculine Testicular Prosthesis Satisfaction Index (TM-TPSI), a questionnaire tool developed for this cohort. <b>Results:</b> Forty-four patients (mean age 40 ± 10 years) received solid silicone prostheses; median follow-up was 84.5 (IQR 65.3–95.0) months. Complications included superficial surgical-site infection in 8/44 (18%), one prosthesis contamination requiring removal, one extrusion requiring replacement, and one migration requiring repositioning (2%). Mean time to explant/reposition was 57.7 ± 61.5 months; the 5-year EFS rate was 97%. Of 41 respondents to the TM-TPSI, 84% were “mostly satisfied” or “more satisfied than unsatisfied”; the mean score was 46.0 ± 10.5. <b>Conclusions:</b> In this cohort, TM-TPI showed a low rate of surgical revisions and high patient-reported satisfaction over long-term follow-up. Multicentre studies and formal validation of the TM-TPSI are warranted to refine benchmarks and enable cross-cohort comparisons. TM-TPI is a procedure that needs to be further investigated with clear specificity for AFAB men.
KW  - Testicular prosthesis; gender affirming genital surgery; transgender men; complications; satisfaction; questionnaire

DO  - 10.32604/cju.2026.076284