Two of LMC’s Andrologists, Mr Alnajjar and Prof Muneer, along with other experts in the field, have recently published a study looking at current international guidelines to compare and summarise the most up to date and major recommendations for the management of small testicular masses (STMs).
Objective and Method
Systematic reviews of various relevant journals were carried out up until November 2024, bringing together the current international guidelines to help to avoid unnecessary orchidectomy for STMs which are clearly low risk.
The most recent international recommendations (EAU, AUA, NCCN, CUA, and ESMO) were compared on how small testicular masses should be managed.
Results and Conclusion
The research suggests that there is growing agreement that Testis-Sparing Surgery (TSS) can be safely offered in certain patients, preserving hormonal and reproductive function whilst still balancing oncological safety.
Further considerations need to be made, in particular:
- Size thresholds
- Surveillance
- Post-surgery follow ups
The key takeaway from the findings is that Testis Sparing Surgery is increasingly becoming a popular option for small testicular masses, with a need for stronger evidence to guide daily practice.
New Publication from Mr Alnajjar and Prof Muneer
The paper was recently published in BJU International, “Guideline of Guidelines: Management of Small Testicular Masses” and the full article can be found here.
We’d like to congratulate everyone involved in the paper and of course, our colleagues Mr Alnajjar and Prof Muneer.
Citation:
Tozzi M, Fallara G, Ferro M, Chierigo F, Bianchi R, Alnajjar HM, Pang KH, Muneer A. Guideline of guidelines: management of small testicular masses. BJU Int. 2026 Mar;137(3):444-453. doi: 10.1111/bju.70131. Epub 2025 Dec 24. PMID: 41437827; PMCID: PMC12907781.