Testicular Sparing Surgery in Small Testicular Lesions: Functional and Oncological Outcomes

ABSTRACT
Objective: To evaluate our testis-sparing surgery ( TSS) experiences in our clinic and outline its oncological and functional outcomes.
Materials and Methods: Patients who underwent TSS due to testicular mass in our clinic between 2008 and 2023 were included in the study. Patients with a mass in solitary testis, bilateral testicular mass as well as patients with a normal contralateral testis and a mass of less than 2 cm or less than 30% of the testicular volume were included in the study. Patient demographics, tumor characteristics, and follow-up data were collected and analyzed statistically.
Results: A total of 26 patients who underwent TSS were evaluated. Germ Cell Tumor (GCT ) was detected in 9 patients, and benign testicular mass was detected in 17 patients. The mean patient age was 25±6.1 (18-69) years. The mean tumor size was 12.9±4.4 (range 7-24) mm in all patients. Patients with GCTs were followed up for a mean of 21.8±7.8 (10-36) months. Local recurrence was observed in one patient during follow-up, and radical orchiectomy was performed. No recurrence or metastasis was observed in other patients during the follow-up period. Benign lesions were followed up for 21.5±9.3 (10-38) months. Recurrence was not observed. There was no significant decrease in testosterone levels after surgery (p=0.3).
Conclusions: Excellent outcomes for benign tumors using TSS were obtained in the present study. TSS could be suggested as a safe and effective treatment option in patients with germ cell tumors, as in the present study. However, more data regarding the potential risks and benefits of TSS with a larger patient series is needed.
Keywords: Bilateral testicular tumor, germ cell tumor, solitary testis, testis sparing surgery