TRAUMA TO THE TESTIS

TRAUMA TO THE TESTIS

The testis can be damaged either by blunt or by penetrating trauma. Injuries can range from simple bruising, through significant intratesticular haematomas to rupture of the tunica albuginea, with very significant collections of blood within the tunica vaginalis (haematocele) ( Figure 86.21 ). If the tunica ruptures, the blood can track into the groin and perineum. Percival Pott , 1714–1788, surgeon, St Bartholomew’s Hospital, London, UK, described chimney sweep’s cancer of the scrotum in 1775. In those days the chimney sweep’s apprentice climbed up inside the chimney . Careful clinical assessment, together with the use of ultra - sound examination, is central to the management of men with a scrotal injury . Ultrasound has excellent sensitivity and speci - ficity in the diagnosis of testicular rupture. If there is testicular vidence that early surgical exploration, rupture, there is good e with debridement and repair of the tunica albuginea, is more ly interven - likely to preserve useful testicular function. Also, ear tion results in orchidectomy in less than 10% compared with the 50% rate in delayed surgery . Summary box 86.11 Scrotal trauma ); as it /uni25CF - /uni25CF

Figure 86.21 Ultrasound of a ruptured testicle with a haematocele (courtesy of Dr Davide Prezzi). In cases of scrotal trauma, surgical exploration is indicated when there is testicular rupture or when there is a rapidly expanding scrotal haematoma Ultrasound is important in the assessment of the injury