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

Abstract

Testicular rupture, one of the most common complications in blunt scrotal trauma, is the rupture of tunica albuginea and extrusion of seminiferous tubules. Testicular rupture is more inclined to young men, and injury mechanisms are associated with sports and motor accidents. After history taking and essential physical examination, scrotal ultrasound is the first-line auxiliary examination. MRI is also one of the vital complementary examinations to evaluate testicular rupture after blunt scrotal trauma. Surgical exploration and repair may be necessary when the diagnosis of testicular rupture is definite or suspicious. Postoperative follow-up is to monitor the relief of local symptoms and changes of testicular functions. This review sums up the literatures about testicular rupture after blunt scrotal trauma in recent 16 years and also refers some new advantages and perspectives on diagnosis and management of testicular rupture.

Testicular Rupture Following Blunt Scrotal Trauma

“…Ultimately, testicular rupture is a surgical diagnosis. Persistent symptoms or a concerning examination along with a corresponding history, regardless of imaging ndings, requires operative exploration [1].…”

“…Point-of-care ultrasound (POCUS) has increasingly been used for early investigation of the acute scrotum [4]. However, the literature is limited to case reports, and two retrospective studies [1,4,5,9,11]. Using a high frequency linear array probe, the testes should be individually visualized.…”

“…Blunt scrotal trauma is a common occurrence in male athletes, but serious injuries are rare despite the vulnerable position of the testicles. e cremasteric re ex, testicular mobility, and the strength of the tunica albuginea all contribute to making testicular trauma uncommon [1]. With the increased use of protective athletic cups, the rates of serious injury have also been reduced.…”

“…e right testis is injured more o en than the le one, because of its greater propensity to be trapped against the pubis or inner thigh [2]. Studies revealed that a 50 kg direct force is required to cause testicular rupture [1]. Severity may vary from a small laceration with minimal extravasation to complete parenchymal destruction [2].…”

Mototrauma of scrotum with rupture of the testis and bilateral traumatic dislocation of testes

“…На долю тупых травм приходится 80 % случаев повреждений органов мошонки, которые обычно односторонние и только примерно в 1 % случаев двусторонние [2]. Разрывы яичек происходят примерно в 50 % случаев тупой травмы мошонки [3]. Травма органов мошонки может приводить к разрыву яичка, гематоцеле, дислокации яичка и гематоме оболочек яичка.…”