Testicular rupture

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Testicular rupture is a rip or tear in the tunica albuginea resulting in extrusion of the testicular contents, including the seminiferous tubules. It is a rare complication of testicular trauma, and can result from blunt or penetrating trauma, although blunt trauma is more likely to cause rupture.

Contents

Testicular rupture, typically resulting from trauma sustained during a motor vehicle crash or sports play, mainly affects those from the ages of 10–30. The main symptoms of testicular rupture are scrotal swelling and severe pain, which can make diagnosis difficult. Testicular rupture should be suspected whenever blunt trauma to the scrotum has been sustained. Treatment consists of surgical exploration with repair of the injury. [1]

Treatment

A potential testicular rupture is evaluated with ultrasound imaging. [2] Testicular rupture is treated with surgery, but the procedure performed depends on the magnitude of the injury and the salvageability of the tissue. An orchiectomy, which is the removal of the affected testis, is done when the testis is not salvageable [3] and leads to reduced semen quality and higher rates of endocrine dysfunction than repair of salvageable tissue. [1]

Prognosis

90% of ruptured testes are successfully repaired when treated surgically within 72 hours; the percentage of successful treatment drops to 45% after this period. Though not typically fatal, testicular rupture can cause hypogonadism, low self-esteem, and infertility. [1] However, if left untreated the damaged tissue may become necrotic, which could lead to death.[ citation needed ]

Related Research Articles

Testicular torsion Medical condition

Testicular torsion occurs when the spermatic cord twists, cutting off the blood supply to the testicle. The most common symptom in children is sudden, severe testicular pain. The testicle may be higher than usual in the scrotum and vomiting may occur. In newborns, pain is often absent and instead the scrotum may become discolored or the testicle may disappear from its usual place.

Testicular cancer Medical condition

Testicular cancer is cancer that develops in the testicles, a part of the male reproductive system. Symptoms may include a lump in the testicle, or swelling or pain in the scrotum. Treatment may result in infertility.

Cryptorchidism is the absence of one or both testes from the scrotum. The word is from the Greek κρυπτός, meaning "hidden", and ὄρχις, meaning "testicle". It is the most common birth defect of the male genital tract. About 3% of full-term and 30% of premature infant boys are born with at least one undescended testis. However, about 80% of cryptorchid testes descend by the first year of life, making the true incidence of cryptorchidism around 1% overall. Cryptorchidism may develop after infancy, sometimes as late as young adulthood, but that is exceptional.

Hydrocele testis Medical condition

A hydrocele testis is an accumulation of clear fluid within the cavum vaginale, the potential space between the layers of the tunica vaginalis of the testicle. A primary hydrocele causes a painless enlargement in the scrotum on the affected side and is thought to be due to the defective absorption of fluid secreted between the two layers of the tunica vaginalis. A secondary hydrocele is secondary to either inflammation or a neoplasm in the testis.

Orchiopexy

Orchiopexy is a surgery to move and/or permanently fix a testicle into the scrotum. While orchiopexy typically describes the operation to surgically correct an undescended testicle, it is also used to resolve testicular torsion.

Spermatocele Medical condition

Spermatocele is a fluid-filled cyst that develops at the head of the epididymis. The fluid is usually a clear or milky white color and may contain sperm. Spermatoceles are typically filled with spermatozoa and they can vary in size from several millimeters to many centimeters. Small spermatoceles are relatively common, occurring in an estimated 30 percent of all people with testes. They are generally not painful. However, some people may experience discomfort such as a dull pain in the scrotum from larger spermatoceles. They are not cancerous, nor do they cause an increased risk of testicular cancer. Additionally, unlike varicoceles, they do not reduce fertility.

Varicocele Medical condition

A varicocele is an abnormal enlargement of the pampiniform venous plexus in the scrotum. This plexus of veins drains blood from the testicles back to the heart. The vessels originate in the abdomen and course down through the inguinal canal as part of the spermatic cord on their way to the testis. Varicoceles occur in around 15% to 20% of all men. The incidence of varicocele increase with age.

Hematocele Medical condition

A hematocele is a collection of blood in a body cavity or potential space. The term most commonly refers to the collection of blood in the tunica vaginalis around the testes, known as a scrotal hematocele. Hematoceles can also occur in the abdominal cavity and other body cavities. Hematoceles are rare, making them harder to diagnose and treat. They are very common especially as slowly growing masses in the scrotum usually in men older than 50 years.

Achilles tendon rupture Medical condition were the tendon at the back of the ankle breaks

Achilles tendon rupture is when the Achilles tendon, at the back of the ankle, breaks. Symptoms include the sudden onset of sharp pain in the heel. A snapping sound may be heard as the tendon breaks and walking becomes difficult.

Testicular pain Medical condition

Testicular pain, also known as scrotal pain, occurs when part or all of either one or both testicles hurt. Pain in the scrotum is also often included. Testicular pain may be of sudden onset or of long duration.

Blunt trauma Physical trauma caused to a body part, either by impact, injury or physical attack

Blunt trauma, also known as blunt force trauma or non-penetrating trauma, is physical trauma or impactful force to a body part, often occurring with road traffic collisions, direct blows, assaults, injuries during sports, and particularly in the elderly who fall. It is contrasted with penetrating trauma which occurs when an object pierces the skin and enters a tissue of the body, creating an open wound and bruise.

Testicular sperm extraction

Testicular sperm extraction (TESE) is a surgical procedure in which a small portion of tissue is removed from the testicle and any viable sperm cells from that tissue are extracted for use in further procedures, most commonly intracytoplasmic sperm injection (ICSI) as part of in vitro fertilisation (IVF). TESE is often recommended to patients who cannot produce sperm by ejaculation due to azoospermia.

Tracheobronchial injury Damage to the tracheobronchial tree

Tracheobronchial injury is damage to the tracheobronchial tree. It can result from blunt or penetrating trauma to the neck or chest, inhalation of harmful fumes or smoke, or aspiration of liquids or objects.

Diaphragmatic rupture Tear in the thoracic diaphragm, usually caused by physical trauma

Diaphragmatic rupture is a tear of the diaphragm, the muscle across the bottom of the ribcage that plays a crucial role in breathing. Most commonly, acquired diaphragmatic tears result from physical trauma. Diaphragmatic rupture can result from blunt or penetrating trauma and occurs in about 0.5% of all people with trauma.

Scrotum Anatomical male reproductive structure

The scrotum or scrotal sac is an anatomical male reproductive structure located at the base of the penis that consists of a suspended dual-chambered sac of skin and smooth muscle. It is present in most terrestrial male mammals. The scrotum contains the external spermatic fascia, testes, epididymis, and ductus deferens. It is a distention of the perineum and carries some abdominal tissues into its cavity including the testicular artery, testicular vein, and pampiniform plexus. The perineal raphe is a small, vertical, slightly raised ridge of scrotal skin under which is found the scrotal septum. It appears as a thin longitudinal line that runs front to back over the entire scrotum. In humans and some other mammals the scrotum becomes covered with pubic hair at puberty. The scrotum will usually tighten during penile erection and when exposed to cold temperatures. One testis is typically lower than the other to avoid compression in the event of an impact.

Orchiectomy Surgical removal of one or both testicles

Orchiectomy is a surgical procedure in which one or both testicles are removed. The surgery is performed as treatment for testicular cancer, as part of surgery for transgender women, as management for advanced prostate cancer, and to remove damaged testes after testicular torsion. Less frequently, orchiectomy may be performed following a trauma, or due to wasting away of the testis or testes. Historically, orchiectomy has been performed as a form of castration, and is still used to neuter dogs and cats for population control.

Scrotal ultrasound Medical ultrasound examination of the scrotum.

Scrotalultrasound is a medical ultrasound examination of the scrotum. It is used in the evaluation of testicular pain, and can help identify solid masses.

Genital trauma is trauma to the genitalia.

A penile injury is a medical emergency that afflicts the penis. Common injuries include fracture, avulsion, strangulation, entrapment, and amputation.

References

  1. 1 2 3 Chang, Andrew J.; Brandes, Steven B. (Aug 2013). "Advances in diagnosis and management of genital injuries". The Urologic Clinics of North America. 40 (3): 427–438. doi:10.1016/j.ucl.2013.04.013. ISSN   1558-318X. PMID   23905941.
  2. Hunter, Stanley R.; Lishnak, Timothy S.; Powers, Andria M.; Lisle, David K. (Apr 2013). "Male genital trauma in sports". Clinics in Sports Medicine. 32 (2): 247–254. doi:10.1016/j.csm.2012.12.012. ISSN   1556-228X. PMID   23522506.
  3. Stein DM, Santucci RA (July 2015). "An update on urotrauma". Current Opinion in Urology. 25 (4): 323–30. doi:10.1097/MOU.0000000000000184. PMID   26049876.