Testicular Doppler ultrasound in scrotal trauma: A diagnostic tool with potentially relevant therapeutic implications

Scrotal trauma is one of the rare causes of genital trauma. Although it is not usually fatal, it generates multiple implications in the social and psychological components, impacting the male reproductive and endocrine functions. Blunt trauma is the most frequent scrotal trauma; however, a non-negligible portion is due to penetrating injuries. Its diagnosis has been clinical and its management has been relegated to exploratory surgical interventions, accompanied by a high testicular loss rate. According to this scenario, timely diagnosis and proper treatment become the management pillars of this entity. Although multiple tools have been described to characterize scrotal lesions objectively, testicular Doppler ultrasound can cost-effectively provide relevant information so as to avoid unnecessary surgical interventions.

Managing traumatic testicular dislocations: what we know after two centuries

Traumatic testicular dislocation (TTD) is a rare consequence of blunt scrotal trauma. A 21-year old gentleman presented with inguinal pain following a motorcycle accident and physical examination revealed absence of both testes within a well-formed scrotal sac with bilateral inguinal swellings. Ultrasonography confirmed viability and location of the testes at the superficial inguinal pouch. He underwent emergent surgical reduction with orchidopexy and was discharged the next day. No evidence of testicular dysfunction or atrophy was noted at follow-up. We reviewed reports of TTDs reported in English over the last two centuries and discuss its occurrence, evolution and management.

Penetrating Scrotal Injury: Two Unusual Case Reports in Children and Brief Review of Literature

Introduction: Scrotal trauma is a rare surgical emergency that accounts for less than 1% of all traumatic injuries. They are more prevalent in 15-40 years age group. Blunt scrotal trauma contributes to about 80% of all scrotal injuries whilst penetrating scrotal injuries constitute the remaining 20%. Penetrating scrotal injuries are however, more rare in children but can result from bicycle handlebars, falls with impalement, and animal bites. Case Reports: We did a retrospective review of our records over a 7-year period for penetrating scrotal injuries and report two (2) cases involving 13-year old and 14-year old males who sustained injuries from a tree branch and an iron rod respectively after falling from heights. Discussion: Penetrating scrotal trauma can present with complex injury patterns involving the testes and other surrounding structures, and all invariably need urgent scrotal exploration. Consequently, both of our cases had immediate surgical exploration with conservative debridement of non-viable tissue and surprisingly both were spared any testicular injury. Conclusion: Penetrating scrotal trauma may spare the testis and the scrotal contents despite the gravity of the injury.

A rare case of testicular dislocation with inguinal hernia as a delayed presentation after scrotal trauma

Testis can be damaged either by blunt or penetrating trauma. Traumatic dislocation of testis is rare sequelae of scrotal trauma. Patients usually present at the time of injury and diagnosis is usually made on emergent basis. However, delayed or missed diagnosis may occur as scrotal injury may be overlooked in the presence of other associated injuries or due to lack of awareness of its possible occurrence. In this article, we report a case of 60 years old gentleman who presented with inguinal hernia with empty left hemiscrotum with history of blunt injury to scrotum 15 years back. The peculiarity of case lies in the fact that the dislocation of testis was diagnosed 15 years after trauma and the displaced testis was found to be atrophic.