Testis-Sparing Surgery (selected cases)
Organ-Preserving Resection of Testicular Tumour in Selected Patients
What is Testis-Sparing Surgery (selected cases)?
Testis-Sparing Surgery (TSS) is performed in highly selected patients with testicular tumours where organ preservation is feasible without compromising oncological outcomes. Indications include bilateral tumours, tumour in a solitary testis, synchronous bilateral tumours, or small tumours (<2 cm) in patients with normal contralateral testis. Intra-operative ultrasound guides complete tumour excision with clear margins while preserving residual normal testicular tissue. The procedure is performed under general or spinal anaesthesia with a hospital stay of Day Care / 1 Day. Success rates reach >90% local control in appropriately selected patients at experienced centres.
How the Procedure Works
Inguinal Access & Cord Control
An inguinal incision is made and the spermatic cord controlled with a soft sling at the internal ring before testicular delivery.
Intraoperative Ultrasound
A sterile intraoperative ultrasound probe is applied to the testis to precisely delineate the tumour margins and guide excision planning.
Tumour Excision
The tunica albuginea is incised over the tumour and the lesion excised with a 3–5 mm margin of normal parenchyma.
Frozen Section Assessment
Multiple biopsies from the excision bed are sent for immediate intraoperative frozen section to confirm clear margins.
Closure & Adjuvant Planning
The tunica albuginea is closed with absorbable sutures and the testis replaced in the scrotum; adjuvant radiotherapy planned if GCNIS identified.
Outcomes
Who Needs This Treatment?
- →Men with bilateral synchronous testicular tumours where bilateral orchidectomy would cause androgen deficiency.
- →Patients with a solitary testis from prior contralateral orchidectomy requiring organ preservation.
- →Those with small (<2 cm) testicular lesions with normal contralateral testis requesting organ preservation.
- →Men with bilateral metachronous tumours where the first side has already been removed.
- →Patients who strongly wish to avoid testosterone replacement therapy.
- →Those in specialised centres where intraoperative ultrasound and frozen section are available.
"Testis-sparing surgery, when correctly indicated, allows us to cure testicular cancer while preserving hormonal and reproductive function. In a young man with bilateral disease, it can be truly life-changing."
— — Dr. Vipin Reddy, Consultant Urologist, Andrologist & Renal Transplant Surgeon
Common Questions
Frequently Asked
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