Abstract：
BACKGROUND: Testicular tumors are the most common malignancies in young adults and their incidence is growing. The implantation of a testicular prosthesis, for example, during orchiectomy is a standard procedure but its frequency in Germany is unknown. This study aims to analyze trends of testicular prosthesis implantation in recent years in Germany.
METHODS: The nationwide German hospital billing database and the German hospital quality reports from 2006 to 2021 were studied.
RESULTS: A total of 12,753 surgical procedures with implantation of testicular prosthesis and 1,244 procedures with testicular prosthesis explantation were included. Testicular prosthesis implantation increased in total from 699 cases in 2006 to 870 cases in 2020 (+11.4 cases/year; p < 0.001). The share of implantation of testicular prosthesis due to testicular tumor decreased from 72.6% in 2006 to 67.5% in 2020 (p < 0.001). The share of implantation due to gender affirming surgery increased from 6.8% in 2006 to 23.3% in 2020 (p < 0.001). The share of implantation due to testicular atrophy decreased from 11.4% in 2006 to 3.4% in 2020 (p < 0.001). Simultaneous implantation of testicular prosthesis during orchiectomy for testicular cancer increased from 7.8% in 2006 to 11.4% in 2020 (p < 0.001). In 2006, 146 hospitals (85%) performed < 5 testicular prosthesis implantation, while 20 hospitals (12%) performed 5-15 implantation procedures and 6 hospitals (3%) performed > 15 testicular implantation surgeries. In 2021, 115 hospitals (72%) performed < 5 testicular prosthesis implantation, while 39 hospitals (25%) performed 5-15 implantation procedures and 5 hospitals (3%) performed > 15 testicular implantation surgeries.
CONCLUSIONS: This study shows that implantation of testicular prostheses is steadily increasing. Explantation rates are low. Besides testicular cancer transgender surgeries were the main driver for increasing case numbers in recent years.
METHODS: The nationwide German hospital billing database and the German hospital quality reports from 2006 to 2021 were studied.
RESULTS: A total of 12,753 surgical procedures with implantation of testicular prosthesis and 1,244 procedures with testicular prosthesis explantation were included. Testicular prosthesis implantation increased in total from 699 cases in 2006 to 870 cases in 2020 (+11.4 cases/year; p < 0.001). The share of implantation of testicular prosthesis due to testicular tumor decreased from 72.6% in 2006 to 67.5% in 2020 (p < 0.001). The share of implantation due to gender affirming surgery increased from 6.8% in 2006 to 23.3% in 2020 (p < 0.001). The share of implantation due to testicular atrophy decreased from 11.4% in 2006 to 3.4% in 2020 (p < 0.001). Simultaneous implantation of testicular prosthesis during orchiectomy for testicular cancer increased from 7.8% in 2006 to 11.4% in 2020 (p < 0.001). In 2006, 146 hospitals (85%) performed < 5 testicular prosthesis implantation, while 20 hospitals (12%) performed 5-15 implantation procedures and 6 hospitals (3%) performed > 15 testicular implantation surgeries. In 2021, 115 hospitals (72%) performed < 5 testicular prosthesis implantation, while 39 hospitals (25%) performed 5-15 implantation procedures and 5 hospitals (3%) performed > 15 testicular implantation surgeries.
CONCLUSIONS: This study shows that implantation of testicular prostheses is steadily increasing. Explantation rates are low. Besides testicular cancer transgender surgeries were the main driver for increasing case numbers in recent years.
摘要：
背景：睾丸肿瘤是年轻人中最常见的恶性肿瘤，其发病率正在增长。睾丸假体的植入，例如,睾丸切除术是一种标准手术，但在德国其频率未知。本研究旨在分析近年来德国睾丸假体植入的趋势。
方法：研究了德国全国医院计费数据库和2006年至2021年的德国医院质量报告。
结果：共包括12,753例睾丸假体植入手术和1,244例睾丸假体植入手术。睾丸假体植入从2006年的699例增加到2020年的870例（11.4例/年；p<0.001）。由于睾丸肿瘤而植入睾丸假体的比例从2006年的72.6%下降到2020年的67.5%(p<0.001)。性别确认手术的植入比例从2006年的6.8%增加到2020年的23.3%(p<0.001)。睾丸萎缩引起的种植比例从2006年的11.4%下降到2020年的3.4%(p<0.001)。睾丸切除术期间同时植入睾丸假体治疗睾丸癌从2006年的7.8%增加到2020年的11.4%(p<0.001)。2006年，146家医院（85%）进行了<5睾丸假体植入，20家医院（12%）进行了5-15例睾丸植入手术，6家医院（3%）进行了>15例睾丸植入手术。2021年，115家医院（72%）进行了<5睾丸假体植入，39家医院（25%）进行了5-15例睾丸植入手术，5家医院（3%）进行了>15例睾丸植入手术。
结论：这项研究表明，睾丸假体的植入稳步增加。探险率很低。除睾丸癌外，变性手术是近年来病例数增加的主要驱动因素。
方法：研究了德国全国医院计费数据库和2006年至2021年的德国医院质量报告。
结果：共包括12,753例睾丸假体植入手术和1,244例睾丸假体植入手术。睾丸假体植入从2006年的699例增加到2020年的870例（11.4例/年；p<0.001）。由于睾丸肿瘤而植入睾丸假体的比例从2006年的72.6%下降到2020年的67.5%(p<0.001)。性别确认手术的植入比例从2006年的6.8%增加到2020年的23.3%(p<0.001)。睾丸萎缩引起的种植比例从2006年的11.4%下降到2020年的3.4%(p<0.001)。睾丸切除术期间同时植入睾丸假体治疗睾丸癌从2006年的7.8%增加到2020年的11.4%(p<0.001)。2006年，146家医院（85%）进行了<5睾丸假体植入，20家医院（12%）进行了5-15例睾丸植入手术，6家医院（3%）进行了>15例睾丸植入手术。2021年，115家医院（72%）进行了<5睾丸假体植入，39家医院（25%）进行了5-15例睾丸植入手术，5家医院（3%）进行了>15例睾丸植入手术。
结论：这项研究表明，睾丸假体的植入稳步增加。探险率很低。除睾丸癌外，变性手术是近年来病例数增加的主要驱动因素。
