(306) Complications and Patient-Reported Satisfaction After Testicular Prosthesis Implantation in Assigned Female at Birth (AFAB) Men

Introduction Testicular prosthesis implantation (TPI) is frequently performed as part of masculinising genital gender-affirming surgery (GGAS), yet prospective data in assigned-female-at-birth (AFAB) men are scarce and patient-reported satisfaction instruments specific to this population are lacking. Objective We aimed to describe complications, device survival and satisfaction after transmasculine TPI (TM-TPI) in a high-volume centre, and to pilot a dedicated patient-reported outcome measure satisfaction questionnaire. Methods We conducted a retrospective cohort study of all AFAB trans men undergoing unilateral or bilateral TM-TPI between May 2007 and April 2025. Demographics, prior GGAS, operative details, and follow-up were abstracted from records. Primary outcomes were postoperative complications (surgical-site infection, contamination, haematoma, prosthesis migration, pain, extrusion) and device survival. Satisfaction at 12 months was assessed with a 13-item Transmasculine Testicular Prosthesis Satisfaction Index (TM-TPSI) developed for this cohort (Likert scales; categorised into four satisfaction levels). Descriptive statistics were calculated using Jamovi software. Results Forty-four AFAB patients (mean age 40±10 years; 47.7% smokers) received solid silicone prostheses; most (93.2%) had prior phalloplasty and underwent TM-TPI with an inflatable penile prosthesis, typically placing a single testicular implant contralateral to the pump. Median follow-up was 83.5 months (IQR 65.3–95.0). Overall, 8/44 (18.2%) developed superficial surgical-site infection (3/44, 6.8% required antibiotics). Major events were uncommon: one contamination with abscess requiring explantation, one extrusion requiring replacement, and one migration requiring repositioning (2.3% each). Mean time to explant/reposition was 56.7±60.5 months; the 5 years explantation-free survival rate was 50.0%. Among 41 respondents, 84.1% were “mostly satisfied” or “more satisfied than unsatisfied”; mean TM-TPSI score 46.0±10.5. Lower scores in dissatisfied participants clustered on weight and comfort items, suggesting targets for counselling and device selection. Conclusions TM-TPI in AFAB trans men is associated with manageable complications, long device survival, and high patient-reported satisfaction. Population-specific counselling (device weight/feel, migration prevention) and standardised follow-up may further optimise outcomes. Multicentre studies and formal validation of the TM-TPSI are warranted to establish benchmarks and enable cross-cohort comparisons. Disclosure No