ABSTRACT

The incidence of bilateral testicular tumors is 1 to 4% and bilateral tumors may present as synchronous or metachronus disease. The most common histological type is seminoma. Testicular intraepithelial neoplasia (TIN) is accepted as a precursor lesion germ cell tumors. The incidence of contra-lateral TIN during radical orchiectomy is 4.9%. Many studies have shown that the secondary tumors have lower risk and better prognosis than the primary tumor, therefore these tumors can be treated by standard methods similar to the primary tumors. Testis sparing surgery is indicated only in select cases. Patients should receive hormone replacement therapy after bilateral orchiectomy. Additionally, issues such as testicular prosthesis placement and for those who have not fathered children yet or wish to have more sperm banking and assisted reproductive techniques should be discussed before surgery.