National analysis of testicular and scrotal trauma in the USA

Abstract

BackgroundTo provide a descriptive analysis of scrotal and testicular trauma in the USA. Additionally, we hypothesized that motorcycle collision would have a higher association with scrotal or testicular trauma and subsequent scrotal or testicular operation, compared to a bicycle collision.MethodsThe National Trauma Data Bank (2007–2015) was queried to identify adult male patients with scrotal or testicular trauma. A multivariable logistic regression analysis was performed.ResultsA total of 8,030 patients (0.23%) had scrotal/testicular injury, with 44.6% involved in blunt trauma. A penetrating mechanism occurred in 50.5% of cases, with assault by firearm (75.8%) being the most common. The median age of the patients was 31 years and the median injury severity score was 8. Most had isolated scrotal or testicular trauma (74.5%), with 48.3% requiring scrotal or testicular operation, most commonly repair of laceration (37.3%). Patients involved in a motorcycle collision had higher risk for scrotal/testicular trauma (OR=5.40, CI=4.40–6.61, p=0.0004) and subsequent scrotal/testicular surgery (OR=4.93, CI=3.82–6.36, p=0.0005), compared to bicycle collision.ConclusionScrotal or testicular trauma is rare but occurs most commonly after assault by firearm. Most patients only have isolated scrotal or testicular trauma, but nearly half require subsequent scrotal or testicular operation. Trauma patients presenting after a motorcycle collision have a higher association of scrotal or testicular trauma and subsequent surgery when compared to those involved in a bicycle collision.

Blunt Trauma Resulting in Testicular Evisceration: A Case Report

“…Similar rates have been reported in military literature [4]. A significant portion of cases is due to blunt traumatic mechanisms; up to 85% is cited in the literature [1,5]. Common causes include traffic accidents, most frequently motorcycle-related, industry accidents involving heavy machinery, and contact sports [1,3,6].…”

“…Scrotal and testicular trauma are uncommon injuries, accounting for less than 1% of overall trauma in the United States [ 1 - 3 ]. Scarcity of these injuries is attributed to the location and mobility of the scrotum [ 3 ].…”

“…Scarcity of these injuries is attributed to the location and mobility of the scrotum [ 3 ]. A recent study using the National Trauma Data Bank found over an eight-year period that testicular and scrotal trauma had a prevalence of only 0.23% [ 1 ]. Similar rates have been reported in military literature [ 4 ].…”

“…A significant portion of cases is due to blunt traumatic mechanisms; up to 85% is cited in the literature [ 1 , 5 ]. Common causes include traffic accidents, most frequently motorcycle-related, industry accidents involving heavy machinery, and contact sports [ 1 , 3 , 6 ]. Testicular rupture occurs in nearly 50% of all blunt scrotal trauma, and delayed treatment can damage testicular functionality or even result in testicular loss [ 7 ].…”

Blast injury of the scrotum

“…The testes and scrotum are relatively protected from severe damage during trauma, due to mobility of the testes within the scrotum, cremasteric reflex, toughness of tunica albuginea, and elasticity of the scrotal skin. [ 1 ] A 50 kg direct force is required to cause testicular rupture. [ 2 ]…”