False testicles

False testicles (prostheses or implants) are available to men who have had a testicle removed. They are available in various sizes. These may be made of a reinforced silicone elastomer (a rubber-like substance), which are solid if incised, or they may be gel-filled and slightly softer. In the USA it is also possible to find implants that are filled with saline.

A recent research study found that about three quarters of those who received a false testicle were pleased with them. About a quarter felt dissatisfied about the size, shape, or weight, and 10% wished they hadn’t had one.

Today, complications of infection, leaking or pain are rare.

A few of the men interviewed here said that the subject of a false testicle had not been discussed with them. One young man, diagnosed in 2001, was adamant that the subject had never been raised.

Says that he was not offered a false testicle when he had the orchidectomy and that men should be…

Age at interview 21

Gender Male

Age at diagnosis 21

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Perhaps one thing I should mention I was never offered an artificial testicle.

I was going to ask you about that.

Never, no mention, absolutely nothing. I’ve been asked so many times by people “Oh I guess you had an artificial one put in.” No mention, no, never got asked. Which people were so stunned about. They’re like, “You are joking?” and I’m like “No.”

Would you consider having that done now if you were offered one?

No. Again as I said I’m not ashamed of it, it doesn’t bother me one little bit, you can’t hardly tell to look at it. It doesn’t, you know obviously if people want to stare at my, you know, my private parts, then obviously that’s their problem, in the showers and things, but you know (laughs) if someone said to me “Oh you’ve only got one,” I’d say, “Well what you looking for?” you know that would my obvious reply to them. But it doesn’t bother me. But again would people, should people be asked? I guess so, they should be asked if they want to have an artificial one put in.

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Although most men said that losing a testicle had not had an adverse long-term effect on their feelings about their masculinity (see ‘Masculinity and self-image’), some men said that the surgery had affected self-image, and so decided to have an implant.

Some men were given a choice of having an implant at the same time as the orchidectomy. One man said that his surgeon recommended that a false testicle should be put in at the same time as the orchidectomy or not at all. Another man said that he thought that all men should at least think about having a prosthesis, which he strongly recommended to younger men who might want to have sex without first telling the other person about their past experiences.

Says that he is glad he had a prosthesis and strongly recommends one for a man in his teens or…

Age at interview 46

Gender Male

Age at diagnosis 42

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On the Friday then I was scheduled to go in, my wife came in with me, I was a day patient at the hospital. I had a telephone conversation briefly with the surgeon and I had to talk to him, whether, something that I’d seen from my experience as a doctor was people having testicular prostheses and I asked him whether he thought it might be a good idea to have one. And he didn’t have any strong views but I think he felt since I asked about it, it would probably be a good idea to put one in. And to be honest with you I think in terms of my self-image I feel quite glad that that was done.

Did he show you what it would be like?

No, no because I just had a telephone conversation with him.

Oh right.

And I didn’t know a great deal about testicular prostheses, I mean I again looked on the internet and there were a lot of American Web sites where people were talking about how difficult it was to get them in America because of silicone and all the scares that there had been, and that in this country at that time it was not a particular issue. I don’t know whether it’s an issue now but on balance it seemed to me that there was no compelling reason not to and that from what I knew of myself I’d probably feel a bit better about myself if I did have one. I didn’t feel terribly strongly about it and if I’d been told, “You’re a married man of 40 odd so forget it, this is for teenagers,” I don’t think I’d have felt too hard done by. But as I say I’m quite glad that it was an option. It was an issue I raised, it wasn’t an issue that was raised by them and I think if I hadn’t said anything it wouldn’t have arisen.

For other people who might want to know does it feel very different to you or to your wife?

It doesn’t have any sensation. The prosthesis itself is slightly harder than the normal testis but I think if a doctor examined me hed probably be hard pressed to tell the difference

Oh right.

It has a slightly more sort of squash ball feel about it but it’s the same size and shape as a normal testes.

I think it’s probably worth at least thinking about and discussing with family, the question of a prosthesis, because as I say I was quite glad I had that and it wasn’t something that was immediately offered to me. And I think for somebody having the diagnosis, certainly in their teens or twenties I would strongly recommend having a prosthesis, just because of the issue of self image and you know if you get into a relationship you don’t want to be sort of frightened of having sex without first telling the other person about your experience.

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Some men were only given the option of having a false testicle some time after the initial orchidectomy. Their doctors had not wanted to insert a prosthesis at the same time as the initial operation in case of infection. One man, who had a prosthesis, said that the second operation wasn’t as bad as the first one, that the false testicle was excellent and made him ‘whole again’, and that it made it easier for him to have new relationships. Another man described the procedure, and said that the implant was almost the same as his other testicle in terms of size and density.

Explains that the prosthesis made him feel whole again’, and would make it easier for him to…

Age at interview 46

Gender Male

Age at diagnosis 44

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You mentioned earlier that you were thinking about possibly a prosthesis but it wasn’t offered to you at the time of the operation?

Mm

Did you ever go back and say you would like that or think about it again?

Yes I did, in fact I had it done, yeah. About a year ago I asked the consultant and he said absolutely no problem. So I was fine, I went in and that’s quite a simple operation. They go in through the same scar almost and insert it and they just tack it inside your scrotum so it doesn’t move about. And that was sore for a couple of days, not as bad as the original operation and it’s been fine ever since and I’ve been complimented on it (laughs). I hasten to add by medical professionals (laughs).

Does it feel much different from the other one?

No, not at all no. I mean, I know so it’s , but no it is very, very good. Because theres a lot of negative stuff on the Internet I came across about anti prosthesis that said it can cause all sorts of nasty reactions and you could reject it, it can move about, it’s never the same, but I’ve found it excellent, yeah.

How long ago was that ?

It’s about 12 months yeah. I believe now it’s being offered at the point of the original operation as a matter of course so things change, things move on.

Can you explain, I know it’s quite difficult perhaps to put into words, can you explain why you felt it was important to have a prosthesis?

I suppose it’s , it completes the circle doesn’t it, it sort of makes you whole again, perhaps. I never wanted it to be an issue, I’m not in a relationship at the moment but if I do go into a relationship I don’t want the fact that I’ve got one testicle to be an issue, you know. That’s something I could broach with you know somebody as you get to know them better but I didn’t want it to be an issue from, you know from the start.

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Explains how his false testicle was implanted and says that he is very pleased with it.

Age at interview 48

Gender Male

Age at diagnosis 34

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But then we got to this stage where I wasn’t [happy without a testicle], and to this day I couldn’t tell you what triggered that, it just was, yeah I think I’d like to have one [a false testicle]. You know so I called him up. It was very simple he said, “Yeah fine no problem well arrange it,” and he arranged for me to go in.

I think I waited may be 3 months and I very soon had a bed and he came by and he explained what the procedure was. I asked could I choose the size, he said “No,” I had great visions (laughs). He said, “No, no, no we have small, medium and large and we just match you,” so that’s what it was. And it was a silicone implant that they were going to put in and I asked him how they were going to achieve this. He said “Exactly in the same way that we took the other one out.” So I thought okay fine and that’s exactly what they did. And I was in hospital for no more than 2 days and came out happy again.

How sore was it and how quickly could you walk around and feel alright?

I was walking around the ward the same day that I had the testicle put back in er which was hugely gratifying because you think you know okay you’ve got a wound which is in your abdomen and that is slightly restrictive but really it didn’t hurt an awful lot other than that healing wound there which let’s face I’d been through once before they took it out so I knew what to expect. Er but no it didn’t affect anything otherwise, I just took off and went.

And are you pleased that you had one replaced now?

Absolutely yes because I can flick it and it doesn’t hurt (laughs) which to a man is very important. You’ve probably lost that completely but such is the pain on flicking a real one it’s a great delight to sit in the bath and flick a silicone one and not flinch.

And do you think it matches the other one pretty well?

Absolutely yeah you can barely tell the difference either in size or density. It feels almost exactly the same.

Good.

The only thing that you can tell is different is that it’s , at the base of it theres kind of a, not a clamp but it’s where it’s held in place because if it weren’t tethered by some sort of lead I suppose it would float around and possibly find its way back up into the abdomen. So what they explained was this holds it in place. So that’s the only thing that you can really tell is different but other than that it’s perfectly fine.

Oh good.

Yeah very happy with it.

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One man, diagnosed in 1994, was upset that he wasn’t offered a false testicle. About a year after the initial operation, he raised the subject, but his doctor said it might lead to infection. More recently, when he asked again about having an implant, he was told that the operation would be similar to the initial orchidectomy, and he couldn’t afford to take the time off work.

Says that initially the doctor discouraged him from having a prosthesis and now he would find it…

Age at interview 36

Gender Male

Age at diagnosis 29

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Now we talked about the prosthesis, did you have any more thoughts about that?

I did ask the question, I think it was probably about a year or so afterwards you know, I sort of said, “There was talk of a prosthesis at one point,” and he said, “Well we don’t really like to fit them because they don’t, they’re not always successful.” And basically he tried to talk me out of it. And I did ask again later, only a couple of years back, and you know he sort of like said, “Well yes, well do if you want one, that’s not a problem but,” he said “You’re going to have to go through the same operation as you had to remove the original testicle.” And you know I mean I can’t afford to take time off work, I don’t get paid when I’m not at work. So it would mean at least 2 weeks off work and then quite a lot of discomfort for a couple of months you know until everything is settled down again and it really didn’t seem worth it.

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A few men had problems with their false testicles. One man, who had two false testicles implanted in the 1960’s, suffered a humiliating experience. One implant came through the scrotum and rolled down his trouser leg. The other man, who had two implants in 2001, developed an infection, and so one had to be removed.

Explains that one of his false testicles became infected and was then removed.

Age at interview 26

Gender Male

Age at diagnosis 24

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And so when they removed the cancer they implanted two prostheses [he was born with only one testicle], but it got infected. I was in hospital for three days after the operation and I think it was the fifth day after I’d been released from hospital I was at home and the swelling never went down, it was huge. I basically had a small, the size of a small football between my legs. And there was a small cut in the skin, over the prosthesis and as days went by the cut got bigger to the point where one day, one day I was at home, I was in bed and there was a lamp at the foot of my bed and I was looking down at this huge swollen, like a swollen prosthesis; and well it was the skin, I think it was blood and water but I could see the prosthesis coming out and it was see-through.

And it was a nightmare because I literally had to hold it in. And I rang up my GP, because they have someone you can call all night and they said, “Look it will probably be alright, it’s just swelling from your operation.” And I explained that I think what I could see was actually a fake prosthesis trying to get out, basically being forced out, and I was told not to worry too much but to keep a Band-Aid on it and go to the hospital in the morning.

So I did that and I made a mistake, I had breakfast before going to the hospital because I was only in the hospital for 10 minutes before I was, I think it was 10 or 20 minutes, I was operated on straight away and my prosthesis, one of my prostheses was removed. It’s quite ironic, the one that was removed was the one that I’d had, the cancerous one, it was my left hand side, and the one where I’d never ever, ever, ever had a prosthesis was fine. So I had that one removed and I was in hospital for another five days whilst they put a, basically they put a straw in the hole to drain the

Like a drain?

Yes they put a drain in to just drain all the sort of bad blood and like the infectious blood. And with the beauty of hindsight I would’ve had the operation and had the prosthesis put in later.

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One man reported that he found his prosthesis a bit hard; particularly in the early stages when he was getting used to it, and he said he was not sure he’d choose to have one again.

Explains some of the advantages and disadvantages of having a false testicle.

Age at interview 45

Gender Male

Age at diagnosis 40

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I was given the option of whether I wanted a prosthetic implant, basically a plastic ball.

What did you decide about that?

I had one in the end er I wasn’t sure. I think there are a number of things that went through my mind. One I suppose is pure vanity and I was lucky that I was in a long-term relationship. I’d already had a vasectomy so children weren’t really an issue, so I was also very fortunate there. And I’m not quite sure why I did and I’m not quite sure that my choice would be the same again.

Were there any pros and cons given to you?

There were quite a few. Basically the con side is you’re introducing a foreign body into my own body, so there was much higher chances of infection and post-operative problems, slightly more complicated. There were sort of, had been cases earlier on of problems with artificial testicles and with, sort of in the cold they shattered and this sort of thing. But I was promised that the new ones did not have that kind of problem and I was actually given one to see and feel and whatever.

What was it made of?

I’m not sure exactly, it’s a fairly hard plastic. Whether it’s true plastic or silicone or whatever, it feels like a fairly hard plastic, slightly harder than a normal testicle which is one of the reasons why I say I’d think about it twice because I actually had problems with almost bruising because it hung slightly differently than the natural testicle, they were actually, almost bruising effect until everything got used to the new arrangement. So there were times when I wished I hadn’t had it.

Did they put it in at the same time as they removed the testicle?

It was all done exactly the same time. They said, it’s actually quite a straight forward procedure to put in; you know they’ve already made all the incisions and so forth and he said there was really no point in having a second set of surgery to implant. So he would recommend either having it at the same time or not at all. I don’t know whether that’s the standard recommendation but that was definitely his quite definite recommendation. He also said that it’s quite straightforward to remove them again afterwards, it can be an almost outpatient exercise to remove an artificial testicle. And I haven’t had that. I kept my artificial testicle.

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Some of the men decided not to have a false testicle inserted. One, diagnosed in 1998, said that his doctor had discouraged him from having a false testicle because of the possibility of infection. Another man said that since the implant was made of silicone he was a bit concerned about safety. However, he said that if he had been younger and single he would have almost certainly had one.

Recalls that the doctor said that he didn’t think a false testicle was necessary and that it…

Age at interview 36

Gender Male

Age at diagnosis 33

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At that stage did he [the doctor] discuss whether or not he might replace it with a false one, a prosthesis?

He did. I asked him that point and he, he was of the opinion that it wasn’t actually necessary and actually can cause some complications in certain, I mean theres always a risk of infection and things like that. So he actually advised me against it unless I particularly wanted that and I took his advice on that point. I mean I don’t think, I don’t think it’s particularly necessary unless you’re some sort of nude model or something like that (laughs). I mean there are a limited number of people that are going to see, and at the end of the day if you’re just glancing it doesn’t actually look different to what it did before.

Right, that is something that other young men might want to know?

Mm

If they were perhaps in the rugby showers and everything, it’s not too obvious then that you’ve only got one?

No, no, unless someone is studying in a lot of detail, but I mean that doesn’t happen I think in normal day to day life.

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Says that he was concerned about safety, but that if he had been younger and single he would have…

Age at interview 37

Gender Male

Age at diagnosis 37

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The consultant had offered prior to the operation on the day that I went into the hospital Was I interested in having a prosthesis fitted At the time there was a thing about breast implants for women having being cancerous because it was made of silicon or something like that and I just enquired and they said its exactly the same type of product that you would find in the average breast enlargement. And he said most people of my age group are not really that interested but they don’t like the fact that it might be a little bit off balanced or something, they might feel a little bit unsure.

I thought about it for more than a couple of minutes and I realised there was no need for it, for me personally at my age [aged 37], and I knew my wife wouldn’t have minded either, but having something inside me that had no feeling but I could feel was there was worse than you know being left clear so to speak. So that was offered to me but I declined it, there was no real need. If I was single and I was in my early twenties then I would almost certainly have gone for it but as I am now there was no need for it.

So for a guy who is in his early twenties is that because hed be having new partners?

New partners, yeah you’d be, I think personally if I wasn’t in as strong a relationship as I am now, I would be more concerned about having only one testicle because when you actually look at yourself after you’ve recovered from all the operation and all the swellings gone down and all the bruisings gone away you, from the sides it looks normal, but from the front you can see you, you’re only hanging down one way.

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Others asserted that visually it wasn’t obvious that they had lost a testicle, though some said that their remaining testicle hung in the middle, and that when naked it was fairly obvious that one was missing. Two men said that it was more comfortable with only one testicle.

Asserts that it is not obvious to others that he has lost a testicle.

Age at interview 51

Gender Male

Age at diagnosis 46

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Do you think younger men might feel embarrassed if they were in the shower?

No, because you couldn’t tell, you couldn’t tell, by looking, by looking at the sack you can’t tell that you’ve only got one testicle. It’s as simple as that, you just can’t tell. Even me wife had to feel around and say, Are you sure you’ve only got one?’

Did she? Oh right, so that’s reassuring.

Yes, so I mean honestly, if you go in the shower, nobody, unless they say to their mate Look, I’ve only got one that’s it. Nobody would ever know quite honestly.

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Says that if he were naked it would be fairly obvious to others that he had lost a testicle.

Age at interview 34

Gender Male

Age at diagnosis 34

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For other men who might be wondering is it very obvious? Say you were in the shower with a lot of other guys after a game of football or something, would it be obvious that you’d only one testicle there?

Probably I think, I’m not actually sure; I mean it’s certainly obvious to me. I mean it certainly doesn’t hang the same way as it used to, shall we say. So I think it’s , it’s not absolutely, it doesn’t sort of stand out, sort of going, “Hey look I’ve only got one in there,” but I mean it wouldn’t take an awful, much more than a cursory examination to realise, hang on it’s not quite a full packet (laughs).

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Fertility after testicular cancer

The removal of one testicle will not affect a man's ability to father children. However, chemotherapy usually causes infertility during and for a time after...