Scrotal trauma - results of a series of surgically treated patients
Torres, J1; Anacleto, S1; Morais, N1; Cordeiro, A1; Mota, P1; Ribeiro, J1; Lima, E1
1: Hospital de Braga, Portugal
Objectives: The main objective is to present our department’s experience on the surgical treatment of testicular trauma with testicular rupture.
Material and Methods: A retrospective analysis of all the cases of testicular trauma submitted to surgical exploration between 2000 and 2017 was made. The following data was registered: age, trauma mechanism, trauma side, time from trauma to hospital admission, time from admission to surgery, imaging technique, surgical procedure, length of hospital stay and post-operative complications.
Results: 35 patients between 2000 and 2017 suffered testicular trauma and were surgically treated in our center. The mean age was 36.3 years (18 to 68). The most common trauma mechanisms were straddle injury (37%), sports blunt trauma (14%) and aggression (11%). The mean time between the trauma and the hospital admission was 34 hours (4 to 168 h), and the mean time between the admission and the surgical treatment was 5.1 hours. The preferred imaging technique was the ultrasonography, having the TC been used in only one case. The surgical procedure was mainly the removal of necrotic testicular pulp with tunica albuginea closure (22 patients - 62.8%). Additionally, 6 patients were submitted to orchiectomy (17%), 5 patients had no tunica albuginea lesions (14%) and 2 patients removed a testicular prosthesis that ruptured during the trauma. The mean length of stay was 1.73 days and there were no early or late post-operative complications.
Conclusions: According to our experience, the conservative and testicle-sparing approach is a safe alternative to orchiectomy. The tunica albuginea suture after removal of necrotic tissue is associated with a short hospital stay and an absence of early or late complications.
The advantages of these procedure are the most likely preservation of the endocrine and exocrine function of the affected testicle as well as better aesthetic and psychological results. However, there are situations in which the trauma is too severe to use this technique, being the orchiectomy also a safe and simple procedure.
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