J Korean Med Sci.  2017 Oct;32(10):1669-1673. 10.3346/jkms.2017.32.10.1669.

Trends in Testicular Injury in Korea, 1986–2015

Affiliations
  • 1Department of Urology, School of Medicine, Kyung Hee University Hospital at Gangdong, Kyung Hee University, Seoul, Korea. yookoohan@khu.ac.kr

Abstract

The objectives of this study were to investigate patients treated for scrotal trauma at our institute for the last three decades to describe our experience with an emphasis on the etiologies and ultrasonographic findings in these patients. We reviewed medical records of patients who underwent scrotal ultrasonography for evaluation of testicular trauma at our institutes from 1986 to 2015. Trends regarding the etiology of scrotal trauma were evaluated during each decade. The echo pattern and contour definition of the testicular parenchyma and the pattern of hematoma development were recorded to evaluate radiographic findings of testicular injury. The correlation between ultrasonographic and intraoperative findings was assessed. A total of 115 patients were analyzed. Most patients (92.2%) presented with blunt trauma. The most common etiology of testicular trauma was assault during the first and second decades, while injury related to a fall was most common during the third decade. Of the 77 patients (67.0%) who underwent urgent exploration, 46 patients (59.7%) had testicular rupture. Loss of contour definition, heterogeneous echo pattern of the testicular parenchyma, and testicular hematoma showed a moderate to strong degree of correlation with testicular rupture (Spearman correlation co-efficient: 0.5-0.8). Over the past 30 years, the etiology of testicular injury changed from assault to falls or athletic injury and the severity of injury has decreased. Our findings demonstrate the importance of ultrasonography for determining an appropriate management strategy in scrotal trauma. Surgical exploration should be considered in patients with abnormal ultrasonographic findings.

Keyword

Testis; Injury; Ultrasonography; Surgery

MeSH Terms

Academies and Institutes
Accidental Falls
Athletic Injuries
Hematoma
Humans
Korea*
Medical Records
Rupture
Testis
Ultrasonography

Figure

  • Fig. 1 Trend for severity of scrotal trauma during each decade.


Reference

1. Bocchi F, Benecchi L, Russo F, Perucchini L, Bocchi P, Martinotti M, Del Boca C. Early exploratory intervention in scrotal trauma. Urologia. 2013; 80:140–144.
2. Chandra RV, Dowling RJ, Ulubasoglu M, Haxhimolla H, Costello AJ. Rational approach to diagnosis and management of blunt scrotal trauma. Urology. 2007; 70:230–234.
3. Kim SH, Park S, Choi SH, Jeong WK, Choi JH. Significant predictors for determination of testicular rupture on sonography: a prospective study. J Ultrasound Med. 2007; 26:1649–1655.
4. Ragheb D, Higgins JL Jr. Ultrasonography of the scrotum: technique, anatomy, and pathologic entities. J Ultrasound Med. 2002; 21:171–185.
5. Kratzik C, Hainz A, Kuber W, Donner G, Lunglmayr G, Frick J, Schmoller HJ. Has ultrasound influenced the therapy concept of blunt scrotal trauma? J Urol. 1989; 142:1243–1246.
6. Berman JM, Beidle TR, Kunberger LE, Letourneau JG. Sonographic evaluation of acute intrascrotal pathology. AJR Am J Roentgenol. 1996; 166:857–861.
7. Moore EE, Malangoni MA, Cogbill TH, Peterson NE, Champion HR, Jurkovich GJ, Shackford SR. Organ injury scaling VII: cervical vascular, peripheral vascular, adrenal, penis, testis, and scrotum. J Trauma. 1996; 41:523–524.
8. Cass AS. Testicular trauma. J Urol. 1983; 129:299–300.
9. Buckley JC, McAninch JW. Diagnosis and management of testicular ruptures. Urol Clin North Am. 2006; 33:111–116. [vii.].
10. McAninch JW, Kahn RI, Jeffrey RB, Laing FC, Krieger MJ. Major traumatic and septic genital injuries. J Trauma. 1984; 24:291–298.
11. Cass AS, Luxenberg M. Testicular injuries. Urology. 1991; 37:528–530.
12. Morey AF, Metro MJ, Carney KJ, Miller KS, McAninch JW. Consensus on genitourinary trauma: external genitalia. BJU Int. 2004; 94:507–515.
13. Lee SH, Bak CW, Choi MH, Lee HS, Lee MS, Yoon SJ. Trauma to male genital organs: a 10-year review of 156 patients, including 118 treated by surgery. BJU Int. 2008; 101:211–215.
14. Albert NE. Testicular ultrasound for trauma. J Urol. 1980; 124:558–559.
15. McConnell JD, Peters PC, Lewis SE. Testicular rupture in blunt scrotal trauma: review of 15 cases with recent application of testicular scanning. J Urol. 1982; 128:309–311.
16. Lupetin AR, King W 3rd, Rich PJ, Lederman RB. The traumatized scrotum. Ultrasound evaluation. Radiology. 1983; 148:203–207.
17. Anderson KA, McAninch JW, Jeffrey RB, Laing FC. Ultrasonography for the diagnosis and staging of blunt scrotal trauma. J Urol. 1983; 130:933–935.
18. Cass AS, Luxenberg M. Value of early operation in blunt testicular contusion with hematocele. J Urol. 1988; 139:746–747.
19. Ugarte R, Spaedy M, Cass AS. Accuracy of ultrasound in diagnosis of rupture after blunt testicular trauma. Urology. 1990; 36:253–254.
20. Fournier GR Jr, Laing FC, McAninch JW. Scrotal ultrasonography and the management of testicular trauma. Urol Clin North Am. 1989; 16:377–385.
21. Munter DW, Faleski EJ. Blunt scrotal trauma: emergency department evaluation and management. Am J Emerg Med. 1989; 7:227–234.
22. Altarac S. Management of 53 cases of testicular trauma. Eur Urol. 1994; 25:119–123.
23. Micallef M, Ahmad I, Ramesh N, Hurley M, McInerney D. Ultrasound features of blunt testicular injury. Injury. 2001; 32:23–26.
24. Patil MG, Onuora VC. The value of ultrasound in the evaluation of patients with blunt scrotal trauma. Injury. 1994; 25:177–178.
25. Gross M. Rupture of the testicle: the importance of early surgical treatment. J Urol. 1969; 101:196–197.
Full Text Links
  • JKMS
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr