eMedicine Specialties > Urology > Trauma

Testicular Trauma: Follow-up

Author: Richard A Santucci, MD, FACS, Chief of Urology, Detroit Receiving Hospital; Specialist-in-Chief of Urology, Detroit Medical Center; Chief of Urologic Trauma Surgery, Sinai Grace Hospital; Director, The Center for Urologic Reconstruction; Clinical Professor of Urology, Michigan State College of Medicine
Coauthor(s): Ryan P Terlecki, MD, Clinical Instructor in Reconstructive Urology, Department of Urology, Division of Surgery, University of Colorado
Contributor Information and Disclosures

Updated: Apr 22, 2009

Outcome and Prognosis

Traumatic testicular injuries are relatively uncommon. When present, they are most often caused by blunt trauma. History, physical examination, and scrotal ultrasonography with Doppler studies are important in diagnosing and staging these injuries.

Surgical exploration of all testicular penetrating injuries and many blunt injuries has proven to increase testicular salvage rates and decrease morbidity. Early surgical intervention leads to higher salvage rates, shorter hospitalizations, and a more rapid return to baseline activity. Phonsombat et al (2008) found that testicular salvage rates are significantly higher with gunshot wound injuries than with stab wounds and lacerations, as gunshot wounds less commonly involve the spermatic cord.10

Following repair of penetrating testicular trauma caused by conventional bullet wounds, fertility results are approximately 62%. If the wound sustained was the product of high-velocity ammunition, fertility rates are much lower.

 
Acknowledgments

The authors and editors of eMedicine gratefully acknowledge the contributions of previous author, Jong M Choe, MD, FACS, and previous coauthor, Benjamin S Battino, MD, to the development and writing of this article.



More on Testicular Trauma

Overview: Testicular Trauma
Workup: Testicular Trauma
Treatment: Testicular Trauma
Follow-up: Testicular Trauma
Multimedia: Testicular Trauma
References
[ CLOSE WINDOW ]

References

  1. Chandra RV, Dowling RJ, Ulubasoglu M, Haxhimolla H, Costello AJ. Rational approach to diagnosis and management of blunt scrotal trauma. Urology. Aug 2007;70(2):230-4. [Medline].

  2. Buckley JC, McAninch JW. Use of ultrasonography for the diagnosis of testicular injuries in blunt scrotal trauma. J Urol. Jan 2006;175(1):175-8. [Medline].

  3. Joudi FN, Lux MM, Sandlow JI. Testicular rupture secondary to paint ball injury. J Urol. Feb 2004;171(2 Pt 1):797. [Medline].

  4. Frauscher F, Klauser A, Stenzl A, Helweg G, Amort B, zur Nedden D. US findings in the scrotum of extreme mountain bikers. Radiology. May 2001;219(2):427-31. [Medline].

  5. Ko SF, Ng SH, Wan YL, et al. Testicular dislocation: an uncommon and easily overlooked complication of blunt abdominal trauma. Ann Emerg Med. Mar 2004;43(3):371-5. [Medline].

  6. Wan J, Corvino TF, Greenfield SP, DiScala C. Kidney and testicle injuries in team and individual sports: data from the national pediatric trauma registry. J Urol. Oct 2003;170(4 Pt 2):1528-3; discussion 1531-2. [Medline].

  7. Cline KJ, Mata JA, Venable DD, Eastham JA. Penetrating trauma to the male external genitalia. J Trauma. Mar 1998;44(3):492-4. [Medline].

  8. Srinivas M, Degaonkar M, Chandrasekharam VV, Gupta DK, Hemal AK, Shariff A. Potential of MRI and 31P MRS in the evaluation of experimental testicular trauma. Urology. Jun 2002;59(6):969-72. [Medline].

  9. Lee SH, Bak CW, Choi MH, Lee HS, Lee MS, Yoon SJ. Trauma to male genital organs: a 10-year review of 156 patients, including 118 treated by surgery. BJU Int. Jan 2008;101(2):211-5. [Medline].

  10. Phonsombat S, Master VA, McAninch JW. Penetrating external genital trauma: a 30-year single institution experience. J Urol. Jul 2008;180(1):192-5; discussion 195-6. [Medline].

  11. Yap SA, DeLair SM, Ellison LM. Novel technique for testicular salvage after combat-related genitourinary injury. Urology. Oct 2006;68(4):890.e11-2. [Medline].

  12. Ramdas S, Thomas A, Arun Kumar S. Temporary ectopic testicular replantation, refabrication and orthotopic transfer. J Plast Reconstr Aesthet Surg. 2007;60(7):700-3. [Medline].

  13. Yoshimura K, Okubo K, Ichioka K, Terada N, Matsuta Y, Arai Y. Restoration of spermatogenesis by orchiopexy 13 years after bilateral traumatic testicular dislocation. J Urol. Feb 2002;167(2 Pt 1):649-50. [Medline].

  14. Lysiak JJ, Nguyen QA, Kirby JL, Turner TT. Ischemia-reperfusion of the murine testis stimulates the expression of proinflammatory cytokines and activation of c-jun N-terminal kinase in a pathway to E-selectin expression. Biol Reprod. Jul 2003;69(1):202-10. [Medline].

  15. Cross JJ, Berman LH, Elliott PG, Irving S. Scrotal trauma: a cause of testicular atrophy. Clin Radiol. May 1999;54(5):317-20. [Medline].

  16. Baskin LS, McAninch JW. Reconstruction of testicular rupture. In: McAninch JW, ed. Traumatic and Reconstructive Urology. Philadelphia: WB Saunders; 1996:733-6.

  17. Bedir S, Yildirim I, Sümer F, Tahmaz L, Dayanç M, Peker AF. Testicular dislocation as a delayed presentation of scrotal trauma. J Trauma. Feb 2005;58(2):404-5. [Medline].

  18. Bromberg W, Wong C, Kurek S, Salim A. Traumatic bilateral testicular dislocation. J Trauma. May 2003;54(5):1009-11. [Medline].

  19. Brown SL, Dinchman KH. Testicular trauma. In: Atlas of the Urologic Clinics of North America. Vol 6. Philadelphia: WB Saunders; 1998:119-25.

  20. Cass AS. Testicular trauma. J Urol. Feb 1983;129(2):299-300. [Medline].

  21. Cass AS, Luxenberg M. Testicular injuries. Urology. Jun 1991;37(6):528-30. [Medline].

  22. Fournier GR, McAninch JW. Sonography in the staging of testicular trauma. In: McAninch JW, ed. Traumatic and Reconstructive Urology. Philadelphia: WB Saunders; 1996:727-32.

  23. Hendry WF. Testicular, epididymal and vasal injuries. BJU Int. Aug 2000;86(3):344-8. [Medline].

  24. Lrhorfi H, Manunta A, Rodriguez A, Lobel B. Trauma induced testicular torsion. J Urol. Dec 2002;168(6):2548. [Medline].

  25. Mohr AM, Pham AM, Lavery RF, Sifri Z, Bargman V, Livingston DH. Management of trauma to the male external genitalia: the usefulness of American Association for the Surgery of Trauma organ injury scales. J Urol. Dec 2003;170(6 Pt 1):2311-5. [Medline].

  26. Muttarak M, Lojanapiwat B. The painful scrotum: an ultrasonographical approach to diagnosis. Singapore Med J. Jul 2005;46(7):352-7; quiz 358. [Medline].

  27. O'Brien MF, Collins DA, McElwain JP, Akhtar M, Thornhill JA. Traumatic retrovesical testicular dislocation. J Urol. Feb 2004;171(2 Pt 1):798. [Medline].

  28. Sagalowsky AI, Peters PC. Genitourinary trauma. In: Walsh PC, Retik AB, eds. Campbell's Urology. 7th ed. Philadelphia: WB Saunders; 1998:3116-7.

  29. Srinivas M, Chandrasekharam VV, Degaonkar M, Gupta DK, Jha P, Jagannathan NR. Effects of unilateral grade I testicular injury in rat. Urology. Sep 2002;60(3):548-51. [Medline].

  30. van der Horst C, Martinez Portillo FJ, Seif C, Groth W, Jünemann KP. Male genital injury: diagnostics and treatment. BJU Int. May 2004;93(7):927-30. [Medline].

[ CLOSE WINDOW ]

Further Reading

[ CLOSE WINDOW ]

Keywords

testicular trauma, testicle trauma, scrotal trauma, penile injury, testicular rupture, ruptured testicle, ruptured testis, scrotal hematoma, testicular hematoma, blunt testicular trauma, penetrating testicular trauma, degloving testicular trauma, fractured testis, testicular fracture, tunica albuginea, tunica vaginalis, scrotal pain, scrotum, testicle, testicles, testis, testes, testicular dislocation, genital mutilation, spermatogenesis, penetrating testicular injury, blunt testicular injury, hematocele, epididymitis, orchiopexy, orchiotomy, orchiectomy, testicular torsion, testicular atrophy

[ CLOSE WINDOW ]

Contributor Information and Disclosures

Author

Richard A Santucci, MD, FACS, Chief of Urology, Detroit Receiving Hospital; Specialist-in-Chief of Urology, Detroit Medical Center; Chief of Urologic Trauma Surgery, Sinai Grace Hospital; Director, The Center for Urologic Reconstruction; Clinical Professor of Urology, Michigan State College of Medicine
Richard A Santucci, MD, FACS is a member of the following medical societies: American College of Surgeons, American Urological Association, and Société Internationale d'Urologie (International Society of Urology)
Disclosure: Nothing to disclose.

Coauthor(s)

Ryan P Terlecki, MD, Clinical Instructor in Reconstructive Urology, Department of Urology, Division of Surgery, University of Colorado
Ryan P Terlecki, MD is a member of the following medical societies: American Medical Association, American Urological Association, and Phi Beta Kappa
Disclosure: Nothing to disclose.

Medical Editor

Gamal Mostafa Ghoniem, MD, FACS, Fellowship Program Director, Clinical Professor of Surgery, Head, Section of Voiding Dysfunction, Female Urology and Reconstruction, Cleveland Clinic Florida
Gamal Mostafa Ghoniem, MD, FACS is a member of the following medical societies: American College of Surgeons, American Urogynecologic Society, American Urological Association, Florida Medical Association, International Continence Society, and International Urogynaecology Association
Disclosure: Astellas Honoraria Speaking and teaching; Coloplasty Consulting fee Consulting; Uroplasty Consulting fee Consulting

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Shlomo Raz, MD, Professor, Department of Surgery, Division of Urology, University of California at Los Angeles School of Medicine
Shlomo Raz, MD is a member of the following medical societies: American College of Surgeons, American Medical Association, American Urological Association, and California Medical Association
Disclosure: Nothing to disclose.

CME Editor

J Stuart Wolf Jr, MD, FACS, David A Bloom Professor of Urology, Director of Division of Minimally Invasive Urology, Department of Urology, University of Michigan
J Stuart Wolf Jr, MD, FACS is a member of the following medical societies: American College of Surgeons, American Urological Association, Catholic Medical Association, Endourological Society, Society for Urology and Engineering, Society of Laparoendoscopic Surgeons, Society of University Urologists, and Society of Urologic Oncology
Disclosure: Terumo Corporation Consulting fee Consulting; Omeros Corporation Consulting fee Consulting

Chief Editor

Bradley Fields Schwartz, DO, FACS, Professor of Urology, Director, Center for Laparoscopy and Endourology, Department of Surgery, Southern Illinois University School of Medicine
Bradley Fields Schwartz, DO, FACS is a member of the following medical societies: American College of Surgeons, American Urological Association, Association of Military Osteopathic Physicians and Surgeons, Endourological Society, Society of Laparoendoscopic Surgeons, and Society of University Urologists
Disclosure: Nothing to disclose.

 
 
HONcode

We subscribe to the
HONcode principles of the
Health On the Net Foundation

All material on this website is protected by copyright, Copyright© 1994- by Medscape.
This website also contains material copyrighted by 3rd parties.

DISCLAIMER: The content of this Website is not influenced by sponsors. The site is designed primarily for use by qualified physicians and other medical professionals. The information contained herein should NOT be used as a substitute for the advice of an appropriately qualified and licensed physician or other health care provider. The information provided here is for educational and informational purposes only. In no way should it be considered as offering medical advice. Please check with a physician if you suspect you are ill.