Traumatic testicular injuries are relatively uncommon. Severe blunt testicular trauma is an infrequently reported consequence of injury, yet it is associated with significant sequelae. Sciatica results from nerve impingement in the lumbar spine. History, physical examination, clinical findings, and scrotal sonography with doppler studies are important in diagnosing these injuries. This pool of blood stretches the scrotum until its tense, and can lead to infection. Diagnostic workup in testicular trauma ultrasonography of the testes. Testicular trauma is the third mostcommon cause of acute scrotal pain and may result in various degree of damage to the testes. Traumatismo escrotal y testicular etiologia trauma contuso. Las lesiones testiculares vinculadas a traumatismo son variables e incluyen. Stumpfes hodentraumawann konservative, wann operative. When the testicles tough cover is torn or shattered, blood leaks from the wound. Testicular trauma is also known as torsion and is an environmental factor that may affect fertility.
Bilateral testes fractures from blunt scrotal trauma sciencedirect. Clinical hematoceles that are expanding or of considerable size eg. Stumpfes hodentrauma wann konservative, wann operative behandlung. Important is the localization of the hematoma, which can be scrotal, in the cavum serosum testis or within the testicular parenchyma fig. The overall contour remains smooth, as the testicular shape and the tunica albuginea are maintained. Trauma induced testicular torsion is a well recognised entity, the incidence being 48% in most studies reporting on testicular torsion. Isolated epididymal injury after blunt scrotal trauma from. Testicular rupture, like testicular torsion and other serious injuries to the. A testicular fracture appears as a linear hypoechoic band that extends across the testicular parenchyma and represents a break in the normal testicular architecture, figs 12. Blunt testicular injury conservative or surgical treatment. In a followup ultrasonographic study of unilateral testicular trauma, cross and colleagues found that 5 of the 10 patients developed atrophy of the injured testis, defined as a reduction in volume of more than 50% compared.
This document was amended in july 2016 to reflect literature that. Testicular trauma or testicular torsion is a condition in which the testicle twists on the cord that attaches the testicle to the body. Use of ultrasonography for the diagnosis of testicular injuries in blunt scrotal trauma. Testicular dislocation is an uncommon injury after blunt scrotal trauma with only 150 cases reported that must be properly diagnosed and treat in order to avoid a testicular atrophy. Pdf download for assessment and management of testicular pain, open epub. Caracterizado por dor intensa local irradiada, as vezes. Testicular trauma, male infertility and sperm health mens. A patient is described with trauma induced testicular torsion who presented on three occasions before a decision was. Testicular trauma may lead to groin pain that can result from nerve damage, causing electric, shooting pain. The aasts list of organ injury scaling tables originated in a set of papers that published in the journal of trauma.
Pdf diagnosis and management of testicular injuries. Chief resident grand rounds suny downstate medical center. Etiologically we can categorize testicular trauma in blunt or penetrating. A read is counted each time someone views a publication summary such as the title, abstract, and list of authors, clicks on a figure, or views or downloads the fulltext. Preparacion preoperatoria profilaxis antimicrobiana en trauma tismos. Urologia practica 2011 traumatismo escrotal y testicular. Early scrotal exploration in cases of testicular rupture is thought to be associated with improved testicular salvage rates. Testicular torsion is defined as a torsion of the spermatic cord resulting in the loss of blood supply to the testicle. Testicular torsion is a twisting of the spermatic cord and its contents and is a surgical emergency affecting 3. A rotura testicular ocorre em aproximadamente 50% dos traumatismos no penetrantes directos do escroto. Torsion of the testis synonymous with torsion of the spermatic cord. Testicular cell damage was examined by he staining. Answers from doctors on testicular trauma treatment.
Surgical exploration becomes a must in case of testicular rupture and large haematoceles. Um traumatismo no penetrante do escroto pode causar deslocao testicular, rotura. Blunt injury eg, from an athletic accident or motor vehicle collision is the most common cause of scrotal trauma, followed by penetrating injury from gunshot or other assault. Clipping is a handy way to collect important slides you want to go back to later. Traumainduced testicular rupture karen having, ronnette. Manual reduction or surgical exploration is the treatment of choice in the case of a.
Urotrauma guideline american urological association. Figure 1ultrasound of the right testicle revealing penetrating trauma. Testicular trauma is when a testicle is hurt by force. Testicular pain can be a particularly challenging problem to manage in. Scribd is the worlds largest social reading and publishing site. Injury scoring scale a resource for trauma care professionals. Now customize the name of a clipboard to store your clips.
We present a case of an isolated epididymal injury incurred after scrotal trauma from a high velocity paintball round. Sep 18, 2019 the american urological association recommends early scrotal exploration in all patients suspected of testicular rupture to prevent testicular loss, infection, chronic pain, infertility, and altered selfimage. Because the testes are located within the scrotum, which hangs outside of the body, they do not have the protection of muscles and bones. Testicular rupture is a rare type of testicular trauma. Injury scoring scale the american association for the. Testicular tuberculosis tb is an uncommon presentation of extrapulmonary tb. Assessment and management of testicular pain peter smith. Tunel and active caspase3 immunostaining were used to detect germ cell apoptosis. Blunt scrotal trauma is typically unilateral and involves compression of the scrotal contents. Keywords testicular rupture 4 blunt trauma 4 testis 4. Traumatic dislocation of the testis is a rare event after blunt trauma of the. This can happen when the testicle receives a forceful direct blow or when the testicle is crushed against the pubic bone the bone that forms the front of the pelvis, causing blood to leak into the scrotum. Trauma to the testicle or scrotum can harm any of its contents.
The signs and symptoms of testicular torsion may easily be mistakenly attributed to preceeding testicular trauma if there was such an event. However, the aast does not hold the to this material. We present a unique case of blunt scrotal trauma causing bilateral testes rupture in. Types of injuries include blunt, penetrating and degloving. May, 2015 isolated epididymal injury without associated underlying scrotal or testicular injury in the setting of blunt trauma is exceedingly rare. Testicular trauma is an injury to one or both testicles. The most specific findings on ultrasonography are loss of testicular contour and heterogenous echotexture of parenchyma, which should prompt testicular repair. Testicular pain, scrotal hematoma, soft tissue injuries depending on the etiology of testicular trauma. Sep 18, 2019 testicular atrophy is most likely the result of the original testicular trauma rather than efforts to salvage the testis. Testicular trauma can occur with multiple different mechanisms, but blunt trauma is the most common in athletes. Pathology testicular rupture and testicular ischemiainfarct are two severe complications which need to be ruled ou. The most common mechanism of injury in athletes is from direct impact from falls, kicks, ball contact, and impact on vehicles or bicycles. Management of testicular rupture after blunt trauma in children.
Pdf testicular injuries are seldom because of the mobility of the testes and their anatomical position between the thighs, which offers them. The left testis is located in the inguinal canal with empty left hemiscrotum. The case presented is a classic example of testicular rupture with necrosis resulting from testicular trauma. Trauma often may result in hematoma, hydrocele, hematocele, testicular fracture, or testicular rupture. Within the scrotum, the testicles are secured at either end by a structure called the spermatic cord.
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