Sports-related Genitourinary Injuries Presenting to United States Emergency Departments

Bagga, Herman S.; Fisher, Patrick B.; Tasian, Gregory E.; Blaschko, Sarah D.; McCulloch, Charles E.; McAninch, Jack W.; Breyer, Benjamin N.

doi:10.1016/j.urology.2014.07.075

Cited by 34 publications

(19 citation statements)

References 29 publications

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“…5 Cutting the median bar of the zip with bone or wire cutters to separate the two faceplates and release entrapped skin is one known method. 6 Others have noted that complete separation of the faceplates can be difficult and have therefore proposed limited separation of these elements to relieve entrapment.…”

Section: Discussionmentioning

confidence: 99%

How to resolve zip injury of prepuce? Better way of manipulation

Thakkar

Patel

2019

Int Surg J

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Background: Entrapment of prepuce in a zipper is a common cause of prepuceal injury in children. It is seen in boys of age group 5-12 years who usually do not wear underpants. About 80% of these injuries occur accidentally while zipping up.Methods: We reported 20 cases with zipper injury during our study period, which were divided in two groups. In Group A, Patients were managed by conventional techniques while in Group B; we managed patients with our technique of manipulation. Final Outcomes were compared with need of circumcision.Results: All patients in this study were male patients. All were from pediatric age group, except one case in Group A was Adult. In Group A, 7 patients (70%) required Circumcision while in Group B study, only 1 patient (10%) required circumcision. Moreover we found this technique more Simple and Easy.Conclusions: We found this technique very easy, less time consuming, less trauma to prepuce and need of Circumcision is less with this manipulation.

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Section: Discussionmentioning

confidence: 99%

How to resolve zip injury of prepuce? Better way of manipulation

Thakkar

Patel

2019

Int Surg J

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“…Most blunt scrotal trauma is sporting-related and occurs in males between the ages of 3 and 45 year old. 6 Congeni and colleagues surveyed 755 male high school and collegiate athletes on genitourinary injury awareness. Up to 47% of high school and collegiate athletes reported not wearing genitourinary protective gear during sporting activity and only one-third reported that they would seek medical attention for testicular pain and swelling.…”

Section: Discussionmentioning

confidence: 99%

Isolated epididymal injury after blunt scrotal trauma from high velocity paintball round

Dale

Hoag

2015

CUAJ

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Isolated epididymal injury without associated underlying scrotal or testicular injury in the setting of blunt trauma is exceedingly rare. We present a case of an isolated epididymal injury incurred after scrotal trauma from a high velocity paintball round. Ultrasound demonstrated an enlarged, hypoechoic left epididymis with no evidence of underlying testicular injury. This case highlights the importance of obtaining imaging to evaluate for signs of testicular rupture, potentially obviating the need for surgery. It also reinforces the need for appropriate protective gear when participating in activities with potential for high velocity scrotal trauma. Case reportA 36-year-old man presented to the emergency department with scrotal pain, swelling, and bruising to his left hemiscrotum. Three days prior, he had been shot in the scrotum with a paintball gun while attending a bachelor party. His medical history was unremarkable other than previous bilateral inguinal hernia repair. Physical examination demonstrated left scrotal swelling and tenderness. A palpable, moderate-sized hematoma was appreciated within the left hemiscrotum.Scrotal ultrasound demonstrated symmetrical and homogenous testes, with right and left testes measuring 5.0 × 2.5 × 2.7 cm and 2.9 × 2.9 × 4.6 cm, respectively. The left epididymis appeared enlarged, thickened, and heterogeneous in echotexture with an associated small hematocele (Fig. 1). These findings were consistent with an isolated epididymal hematoma with no evidence of testicular injury.Our patient was managed expectantly with analgesics, ice, and scrotal support. In follow-up 1 week later, his pain had resolved and the swelling had decreased. On physical examination, the size of his scrotal hematoma had significantly decreased. DiscussionBlunt scrotal trauma is most often caused by athletic injury (50%), motor vehicle collision (9%-17%), or assault, and comprises less than 1% of trauma-related injuries.1,2 Possible injuries include testis rupture, avulsion, torsion, and hematoma. However, isolated epididymal injury without accompanying scrotal or testicular injury is exceptionally rare. Clinical evaluation of the painful, swollen scrotum can be difficult, especially when trying to delineate between pathology requiring surgical intervention versus conservative management. Before widespread use of ultrasound as a diagnostic adjunct, surgical exploration was the standard of care. Early surgical exploration leads to high testicular salvage rates along with reduced rates of delayed orchiectomy. 4 However, with high-resolution colour Doppler ultrasound, serious scrotal injuries requiring surgical repair, including testicular rupture and avulsion, can be ruled out with sensitivity approaching 100%.5 Appropriate selection of patients for conservative management can avoid unnecessary surgery and its associated complications. In patients with high-risk mechanisms and with unclear imaging findings, surgical exploration remains prudent.This case highlights the importance of genitourinary pr...

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“…Additionally, the NEISS uses validated algorithms created by the CPSC, utilizing cluster variables and sample weighting to calculate estimates of national injury incidence totals for large‐scale data interpretation. Secondary to these strengths, the NEISS has been utilized in numerous analyses spanning a variety of medical specialties …”

Section: Methodsmentioning

confidence: 99%