Testicular trauma
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
Diagnosis
- Scrotal ultrasound required for all blunt testicular injuries
- Reliable in diagnosing ruptured testes
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
Management
- Most testicular injuries are managed conservatively
- Analgesia, ice, elevation, scrotal support, urology f/u
- Consult Urology for urgent operative care
- Testicular rupture
- Testicular dislocation (absence)