Rupture of silicone gel filled testicular prosthesis: Causes, diagnostic modalities and treatment of a rare event

J. Joris Hage, Annette H M Taets Van Amerongen, Paul J. Van Diest

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: Rupture of the envelope of silicone gel filled testicular prostheses is rare and alleged to be unlikely without intraoperative needle puncture. We observed that it may be caused by chronic intermittent trauma or a single acute increase of pressure, and report diagnostic and therapeutic modalities. Materials and Methods: Four cases treated by us during the last 10 years are presented. One patient had testicular implants for Klinefelter's syndrome, whereas the other 3 had been treated for female-to-male transsexualism. Diagnosis was confirmed by ultrasonography and magnetic resonance imaging. The fibrous capsule surrounding the ruptured prosthesis was left intact to allow en bloc surgical extirpation. Histological evaluation of the resected specimen was performed. Results: Rupture of silicone gel filled testicular implants may be caused by acute or chronic pressure without intraoperative needle puncture. Conclusions: Magnetic resonance imaging offers superior diagnostic accuracy and should be regarded the gold standard in the evaluation of implant rupture. Ultrasonography is an accept-able alternative. In cases when gross symptoms of scrotal inflammation are lacking replacement of implants is facilitated by the fibrous capsule that forms around any prosthesis. Transcapsular migration of silicone particles was observed even when the fibrous capsule was intact.

Original languageEnglish (US)
Pages (from-to)467-471
Number of pages5
JournalJournal of Urology
Volume161
Issue number2
StatePublished - Feb 1999
Externally publishedYes

Keywords

  • Artificial
  • Implants
  • Prosthesis
  • Ultrasonography

ASJC Scopus subject areas

  • Urology

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