Testicular trauma: Difference between revisions
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== | ==Background== | ||
[[File:Gray1144.png|thumb|Scrotal anatomy]] | |||
[[File:Figure 28 01 02.jpg|thumb|Scrotal anatomy]] | |||
[[File:Figure 28 01 03.jpg|thumb|Testicular anatomy]] | |||
[[File:Illu testis surface.jpg|thumb|1. Epididymis 2. Head of epididymis 3. Lobules of epididymis 4. Body of epididymis 5. Tail of epididymis 6. Duct of epididymis 7. Deferent duct (ductus deferens or vas deferens)]] | |||
==Clinical Features== | |||
*Blunt trauma due to impingement against symphysis pubis | *Blunt trauma due to impingement against symphysis pubis | ||
**Will have contusion or rupture based on whether tunica albuginea is disrupted | **Will have contusion or rupture based on whether tunica albuginea is disrupted | ||
**Large, blue, tender scrotal mass (hematocele) | **Large, blue, tender scrotal mass (hematocele) | ||
*Testicular dislocation | |||
**Absent testicle | |||
== | ==Differential Diagnosis== | ||
{{Lower GU trauma DDX}} | |||
{{Testicular DDX}} | |||
== | ==Evaluation== | ||
[[File:PMC4332640 10.1177 1941738114537786-fig4.png|thumb|Images of the for testicular trauma: normal anatomy, testicular rupture, hematoma, and torsion.]] | |||
[[File:PMC4332640 10.1177 1941738114537786-fig2.png|thumb|Sagittal ultrasound demonstrating a boundary between the subcapsular hematoma and testicle (white arrows). There is a loss of the clear tunica vaginalis along the right portion of the image, which is concerning for testicular rupture (orange arrow), compared with the intact tunica vaginalis (blue arrow).]] | |||
*[[Scrotal ultrasound]] required for all blunt testicular injuries | |||
**Reliable in diagnosing ruptured testes<ref>Buckley JC, McAninch JW. Use of ultrasonography for the diagnosis of testicular injuries in blunt scrotal trauma. J Urol 2006;175:175-8.</ref> | |||
==Management== | |||
*Most testicular injuries are managed conservatively | *Most testicular injuries are managed conservatively | ||
**Analgesia, ice, elevation, scrotal support, urology | **[[Analgesia]], ice, elevation, scrotal support, urology follow up | ||
* | *Consult Urology for urgent operative care | ||
**[[Testicular rupture]] | |||
**Testicular dislocation (absence) | |||
==Disposition== | |||
*See above. Depends on underlying diagnosis identified. | |||
==See Also== | ==See Also== | ||
*[[GU Trauma]] | *[[GU Trauma]] | ||
*[[Testicular | *[[Testicular diagnoses]] | ||
==External Links== | |||
==References== | |||
<references/> | |||
[[Category: | [[Category:Urology]] | ||
[[Category:Trauma]] | [[Category:Trauma]] | ||
Latest revision as of 17:44, 3 May 2023
Background
Clinical Features
- Blunt trauma due to impingement against symphysis pubis
- Will have contusion or rupture based on whether tunica albuginea is disrupted
- Large, blue, tender scrotal mass (hematocele)
- Testicular dislocation
- Absent testicle
Differential Diagnosis
Genitourinary Trauma
- Urinary system
- Genital
- Other
- Child abuse
- Pelvic fracture (often accompanies)
- Sexual assault
Testicular Diagnoses
- Scrotal cellulitis
- Epididymitis
- Fournier gangrene
- Hematocele
- Hydrocele
- Indirect inguinal hernia
- Inguinal lymph node (Lymphadenitis)
- Orchitis
- Scrotal abscess
- Spermatocele
- Tinea cruris
- Testicular rupture
- Testicular torsion
- Testicular trauma
- Testicular tumor
- Torsion of testicular appendage
- Varicocele
- Pyocele
- Testicular malignancy
- Scrotal wall hematoma
Evaluation
Sagittal ultrasound demonstrating a boundary between the subcapsular hematoma and testicle (white arrows). There is a loss of the clear tunica vaginalis along the right portion of the image, which is concerning for testicular rupture (orange arrow), compared with the intact tunica vaginalis (blue arrow).
- Scrotal ultrasound required for all blunt testicular injuries
- Reliable in diagnosing ruptured testes[1]
Management
- Most testicular injuries are managed conservatively
- Analgesia, ice, elevation, scrotal support, urology follow up
- Consult Urology for urgent operative care
- Testicular rupture
- Testicular dislocation (absence)
Disposition
- See above. Depends on underlying diagnosis identified.
See Also
External Links
References
- ↑ Buckley JC, McAninch JW. Use of ultrasonography for the diagnosis of testicular injuries in blunt scrotal trauma. J Urol 2006;175:175-8.