Efficacy of partial orchiectomy focusing on testis growth and development in prepubertal testicular tumors: a retrospective study

Abstract

PurposeAlthough partial orchiectomy (PO) for prepubertal testicular tumor is widely accepted and has favorable oncological outcomes, its effect on testicular growth and development is unclear. We aimed to assess the efficacy of PO in prepubertal testicular tumors, focusing on postoperative testicular growth and development.Materials and MethodsThis retrospective study included 60 patients who underwent PO at Severance Children's Hospital between July 2007 and June 2022. Testicular volume was measured by using ultrasonography before and after surgery, and PO was performed via a scrotal incision approach.ResultsThe median age at operation was 2.5years, and the median follow-up period was 7.0years. All cases were confirmed benign by postoperative pathological examination. The ipsilateral (affected side) testis volume decreased from 2.87 to 0.90 cm & sup3; postoperatively, whereas the contralateral testis volume increased from 0.65 to 0.82 cm & sup3;. Testicular atrophy was observed in 13 patients, and there was a significant correlation between the risk of testicular atrophy and age at surgery. Patients who underwent PO before 1year of age had a higher risk of atrophy (OR = 10.44, 95% CI 1.99-54.90, p = 0.006). Postoperative hematoma occurred in 8 patients, but none required further treatment or intervention. No malignancy or recurrence was observed during follow-up.ConclusionPartial orchiectomy is oncologically viable for the management of prepubertal testicular tumors. However, caution is advised in young patients because of the risk of testicular atrophy. Although PO after 1year of age may better preserve testicular growth, the timing of surgery should be individualized.