Testicular Rupture Following Blunt Scrotal Trauma

Testicular rupture after blunt scrotal trauma is characterized by rupture of the tunica albuginea and extrusion of seminiferous tubules. This is a serious injury and appropriate evaluation and management are necessary both for symptom control, but also for preservation of the testicle. Clinical examination of the scrotum following trauma is difficult and may result in incorrect triage of patients for surgical exploration. This case study describes the assessment and management of blunt testicular trauma in an adolescent lacrosse player.

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Testicular Rupture or Testicular Fracture? A Case Report and Literature Review

Case Reports in Urology ◽

10.1155/2018/1323780 ◽

2018 ◽

Vol 2018 ◽

pp. 1-3

Author(s):

Firas Addas ◽

Sylvia Yan ◽

Marios Hadjipavlou ◽

Michael Gonsalves ◽

Samer Sabbagh

Keyword(s):

Case Report ◽

Literature Review ◽

Tunica Albuginea ◽

Severe Injuries ◽

Surgical Exploration ◽

Complete Rupture ◽

Testicular Rupture ◽

Testicular Trauma ◽

Fracture Diagnosis

Testicular trauma is relatively uncommon. However, severe injuries can result in many complications and should be carefully diagnosed and managed. We present a case of testicular fracture diagnosis made by ultrasonography. The surgical exploration revealed the fracture as well as complete rupture of the tunica albuginea. Testicular rupture is the disruption of the tunica albuginea, while testicular fracture is a “break” in the testicular parenchyma. Management could be conservative in mild fracture cases without rupture while suspected or confirmed fracture should be treated by surgical exploration.

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Intra-Testicular Papaverine Injection for Testicular Salvage after Blunt Testicular Trauma: A Case Report

Current Urology ◽

10.1159/000499283 ◽

2019 ◽

Vol 13 (2) ◽

pp. 110-112

Author(s):

Kevin Keating ◽

Paulette C. Dreher ◽

Jason Levy ◽

Brian McGreen ◽

Daniel Edwards ◽

...

Keyword(s):

High Speed ◽

Motor Vehicle ◽

Primary Repair ◽

Tunica Albuginea ◽

Current Evidence ◽

Common Mechanism ◽

Surgical Interventions ◽

Surgical Exploration ◽

Valuable Treatment ◽

Testicular Trauma

Blunt trauma is the most common mechanism of injury to the scrotum and testicle. Surgical exploration with primary repair, hematoma evacuation, and de-torsion are common surgical interventions. A 20-year-old male with no previous medical history presented after a high-speed motor vehicle collision. Ultrasonography demonstrated heterogeneous changes of the tunica albuginea and decreased arterial flow to bilateral testicles. He was subsequently taken to the operating room for surgical exploration, which revealed bilateral mottled testes with questionable viability. Papaverine was injected into each testicle, which resulted in visibly increased perfusion and subsequent preservation of the testicles. Conclusion: Current evidence on the use of papaverine is isolated to testicular torsion. Additional research should be conducted on the use of papaverine in blunt testicular trauma. Papaverine injection may be a valuable treatment option when inadequate perfusion is observed intra-operatively.

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Diagnosis and management of testicular rupture after blunt scrotal trauma: a literature review

International Urology and Nephrology ◽

10.1007/s11255-016-1402-0 ◽

2016 ◽

Vol 48 (12) ◽

pp. 1967-1976 ◽

Cited By ~ 17

Author(s):

Zhao Wang ◽

Jin-rui Yang ◽

Yu-meng Huang ◽

Long Wang ◽

Long-fei Liu ◽

...

Keyword(s):

Literature Review ◽

Diagnosis And Management ◽

Testicular Rupture ◽

Blunt Scrotal Trauma ◽

Scrotal Trauma

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Accuracy of Ultrasonography in Diagnosis of Testicular Rupture After Blunt Scrotal Trauma

Journal of Emergency Medicine ◽

10.1016/j.jemermed.2008.03.022 ◽

2008 ◽

Vol 35 (1) ◽

pp. 112

Author(s):

Benjamin Hatten

Keyword(s):

Testicular Rupture ◽

Blunt Scrotal Trauma ◽

Scrotal Trauma

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Rare case of acute scrotal swelling: Multiple testicular rupture with intraparenchymal lesions and intact tunica albuginea

Urologia Journal ◽

10.1177/039156039205901s84 ◽

1992 ◽

Vol 59 (1_suppl) ◽

pp. 258-260

Author(s):

C. Lania ◽

M. Grasso ◽

M. Castelli ◽

E. Angeli ◽

A. Del Maschio ◽

...

Keyword(s):

Differential Diagnosis ◽

Rare Case ◽

Ultrasound Examination ◽

Tunica Albuginea ◽

Age Group ◽

Surgical Exploration ◽

Normal Limits ◽

Testicular Rupture ◽

Scrotal Swelling ◽

Haemorrhagic Necrosis

Bilateral testicular rupture is rare. Incidence is highest in the 16–20 age group. There are no specific signs or symptoms which make a differential diagnosis between testicular rupture and scrotal traumas possible. Examination at Doppler and ultrasonography and early surgical exploration provide early diagnosis, which is necessary to safeguard fertility. We report one case of bilateral orchialgia, following a diving episode. Ultrasound examination of the scrotum showed bilateral multiple areas of altered echogenicity of the testicular parenchyma and an intact tunica albuginea. During surgery bilateral multiple areas of haemorrhagic necrosis were drained. Outpatient examination one month after leaving the hospital was normal. At 3 and 6 months the results of seminal examination were within normal limits according to the parameters established by the WHO.

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