Testicular trauma

The testis or testicle is the male gonad, or reproductive organ, responsible for the production of sperm and androgens sex hormonesprimarily testosterone. The testicle is contained in an extension of the abdomen called the scrotum.

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Within the scrotum, the testicle is surrounded by the tunica vaginalis, epididymis, spermatic cord, and appendix testis which are all important anatomic structures that may be involved in acute testicular trauma. Testicular trauma can occur with multiple different mechanisms, but blunt trauma is the most common in athletes. The most common mechanism of injury in athletes is from direct impact from falls, kicks, ball contact, and impact on vehicles or bicycles.

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Blunt scrotal trauma is typically unilateral and involves compression of the scrotal contents against the pubic bone. A sports medicine physician will review symptoms, and then perform ann examination, which could include the following: inspecting the skin of the scrotum for lacerations, bruising, and any swelling. Swelling and its location should be noted. Once a detailed examination has been performed, further evaluation may be done to guide treatment. At times, advanced imaging using color Doppler ultrasound may be used to assess testicular blood flow and determine if any other abnormalities are present.

Encourage male athletes to wear a protective cup when participating in sports that have a significant risk for testicular injury contact sports such as lacrosse, soccer, baseball, ice hockey, rugby, football, boxing and mixed martial arts. While there are no published guidelines on return to play after a testicular injury or in individuals with one testicle, it is recommended to wear a properly fitted protective cup in any contact sports activities. Rational approach to diagnosis and management of blunt scrotal trauma.

Analysis of nonsexual injuries of the male genitals in children and adolescents. Acta Paediatr. Epub Dec 1. Testicular conditions in athletes: torsion, tumors, and epididymitis. Curr Sports Med Rep. What is it?

Mild injury: When pain and scrotal swelling are minimal, and the testes are normal upon physical examination with an intact scrotum most common injury. Moderate injury: When there is moderate pain and scrotal swelling.

Treatment of testicular trauma will depend on the clinical evaluation and degree of injury: Mild: Treatment consists of bed rest, using ice packs for 20 to 30 minutes three to four times a day as tolerated, supportive underwear briefs instead of boxers and nonsteroidal anti-inflammatory medications, like ibuprofen or naproxen. No further testing or surgical consultation is necessary for these patients if pain resolves quickly. Moderate: Ultrasound imaging, if available, is advisable to identify potential testicular injuries.The testicles are a vital part of the male reproductive systemplaying a role in reproduction and male hormone production.

Due to their location in the scrotum, however, which hangs outside the body, the testicles lack traditional protection structures that most other organs in the body have.

What is Testicular Trauma?

This makes them more susceptible to injury. Testicular trauma refers to anytime a testicle is hurt by force. There are several different types of injuries possible in the testicles, and treatment methods vary between these and the severity of the injury.

The testicles are made of different types of tissue, and the scrotum contains other structures attached to the testicles. Different types of testicular injuries can include:. Extreme pain is typically the first symptom of testicular trauma—in the scrotum, but often in the abdomen as well.

Other symptoms might include:. Testicular trauma injuries are caused specifically by penetrating or blunt forces. Penetrating forces include stabbing or gunshot wounds, where blunt forces include a kick or any hard trauma to the scrotum. After a basic process to determine a positive diagnosis of testicular trauma, your doctor will discuss treatment options with you.

In some minor cases, testicular injuries can be treated at home on your own. In others, a surgeon or other specialist will need to be involved.

Treatments might include:. This information is not intended to replace the advice of a medical professional. You should always consult your doctor before making decisions about your health. Different types of testicular injuries can include: Rupture: When an injury tears the protective coating surrounding the testicle and damages the testicle.

Contusion: When an accident injures blood vessels in the testicle and leads to bleeding and bruising. Torsion: When a tube called the spermatic cord, which contains blood vessels connecting the testicle to the abdomen, is twisted. This can happen due to an injury, or sometimes spontaneously. Hematoceles: When blood collects under a layer of protective covering around the testicle. Dislocation: When an accident pushes the testicle out of the scrotum—often into the abdomen, near the pubic bone over the penis or in other areas near the scrotum.

Epididymitis: Trauma can injure the epididymis and lead to inflammation or infection. Infections: Commonly caused by animal bites to the scrotum. Degloving: This is an injury where the scrotum is torn away, similar to the removal of a glove from a hand.

Treatments might include: Basic approaches: Ice packs on the scrotum, rest and avoidance of strenuous activity are basic approaches to help limit symptoms. Medication : Painkillers for pain and inflammation, or antibiotics for infections.

Jockstrap: To support the testicles during recovery. Surgery: In many cases of testicular injury, surgery is required. This could involve moving the testicle, stitching covering back together, or removing part of all of the testicle in some cases.Testicle pain has a number of possible causes. The testicles are very sensitive, and even a minor injury can cause testicle pain or discomfort. Pain might arise from within the testicle itself or from the coiled tube and supporting tissue behind the testicle epididymis.

Sometimes, what seems to be testicle pain is caused by a problem that starts in the groin, abdomen or somewhere else — for example, kidney stones and some hernias can cause testicle pain.

The cause of testicle pain can't always be identified. Causes shown here are commonly associated with this symptom. Work with your doctor or other health care professional for an accurate diagnosis. Mayo Clinic does not endorse companies or products. Advertising revenue supports our not-for-profit mission.

Any use of this site constitutes your agreement to the Terms and Conditions and Privacy Policy linked below. A single copy of these materials may be reprinted for noncommercial personal use only. This site complies with the HONcode standard for trustworthy health information: verify here. This content does not have an English version. This content does not have an Arabic version. Make an appointment. Visit now. Explore now.

Choose a degree. Get updates. Give today. Request Appointment. Symptoms Testicle pain. Definition Causes When to see a doctor. Products and services. Free E-newsletter Subscribe to Housecall Our general interest e-newsletter keeps you up to date on a wide variety of health topics. Sign up now. Causes By Mayo Clinic Staff. Show references Eyre RC. Evaluation of acute scrotal pain in adults. Accessed Sept. Scrotal pain. Merck Manual Professional Version. Belanger GV, et al.

Diagnosis and surgical management of male pelvic, inguinal, and testicular pain.This clinical guideline on Urotrama discusses diagnosis and management of genitourinary injuries, including renal, ureteral, bladder, urethral, and genital trauma. Unabridged version of this Guideline [pdf]. This document was amended in April to reflect literature that was released since the original publication of this guideline in April This document will continue to be periodically updated to reflect the growing body of literature related to this disease.

Allen F. Armstrong, MD; Benjamin N. Breyer, MD; Joshua A. Broghammer, MD; Bradley A. Hudak, MD; Jeffrey H. Pruitt, MD; James T. Santucci, MD; Thomas G. The authors of this guideline reviewed the urologic trauma literature to guide clinicians in the appropriate methods of evaluation and management of genitourinary injuries. These publications were used to inform the statements presented in the guideline as Standards, Recommendations or Options.

When sufficient evidence existed, the body of evidence for a particular treatment was assigned a strength rating of A highB moderate or C low.

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In the absence of sufficient evidence, additional information is provided as Clinical Principles and Expert Opinions. In Aprilthe Urotrauma guideline underwent an amendment based on an additional literature search, which retrieved additional studies published between original publication and December Forty-one studies from this search provided data relevant to the management and treatment of urotrauma.

Standard; Evidence Strength: Grade B. Clinicians should perform diagnostic imaging with IV contrast enhanced CT in stable trauma patients with mechanism of injury or physical exam findings concerning for renal injury e.

Recommendation; Evidence Strength: Grade C. Clinical Principle.Testicular trauma is an injury of the testes, usually caused by blunt force impact due to traffic accidents, fights or sports injuries. Penetrating or degloving trauma is also possible Buckley and McAninsh, Testicular pain, scrotal hematoma, soft tissue injuries depending on the etiology of testicular trauma.

Conservative treatment of testicular trauma is indicated for mild hematoma without tear of the tunica albuginea and without decreased blood flow of the testis. A testicular rupture may occur later in the course of convervative treatment. Conservative treatment consists of analgesics, elevation of the scrotum, local cooling and bed rest. The scrotal management is necessary for a pronounced hematoma hematocelefor suspected testicular rupture and for a decreased testicular blood flow.

Surgical treatment depends on the intraoperative findings: detorsion of the testis, removal of hematoma or nonviable tissue, suture of the tunica albuginea. Orchiectomy is necessary for patients with complete testicular destruction.

Deutsche Version: Hodenverletzung. With kind permission of Prof. Harzmann, Augsburg. Ultrasonography of a three-days old testicular rupture: on the right side, an intact tunica albuginea is seen, the testicular tissue appears homogeneous there. On the left side, the tunica cannot longer be seen, the prolapsing testicular tissue appears inhomogeneous. Testicular diseases.Victorian government portal for older people, with information about government and community services and programs.

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testicular trauma

They are two small, oval-shaped male sex glands that produce sex hormones and sperm. Each testicle is housed in a fibrous outer covering called the tunica albuginea, which is contained within a sac of skin called the scrotum. The spermatic cord attaches the testicle to the body. Testicular torsion occurs when the spermatic cord twists and cuts off the blood supply to the testicle.

This condition can occur at any age, but tends to be more common between the onset of puberty and the mids. It requires urgent medical attention. Hard physical activity can cause this twisting of the cord. These symptoms can often be confused with an infection of the testicles.

Testicular Swelling Symptoms, Causes & Common Questions

An infection should not be considered until torsion has been ruled out. Urgent medical attention is needed to save the testicle when torsion is diagnosed.

Surgery must untwist the spermatic cord and restore blood flow to the testicle. A doctor uses physical examination and ultrasound scans to make the diagnosis.

testicular trauma

Sometimes, a doctor can only make a conclusive diagnosis at the time of surgical exploration. The survival rate of the affected testicle is poor unless surgery is performed within four to six hours of the injury. Unnecessary investigations should not take place if torsion is suspected, as delays to surgery can affect the viability of the testis. If the blood supply has been disrupted for too long, the testis may not be viable or salvageable, and may need to be removed. In many cases, the surgeon will also secure the spermatic cord on the unaffected side, to prevent future torsion of the other testicle.

If the torted twisted testicle has to be removed, then a surgeon can put a prosthesis or silicone testis into the scrotum for cosmetic reasons usually at a later date. The appendix testicle is a small tissue structure located at the upper third of the testicle.

Torsion of the appendix testicle means that the structure has twisted and cut off its blood supply. This condition is easily confused with testicular torsion because the symptoms are so similar.

However, the onset of pain is slower and the condition often presents with a noticeable blue dot on the surface of the scrotum. This blue dot is the darkened appendix testicle. Surgery is needed to correct the problem, but the testicle is not at risk.

Testicular cancer is an abnormal growth or tumour that appears as a hard and usually painless lump in either testicle. In most cases, testicular cancer can be cured if the person seeks medical treatment early. Surgical removal of the affected testicle orchidectomy is usually the first treatment for all testicular cancer. Testicles are easily injured because they are not protected by muscle or bone. The main types of possible injuries include:. A doctor can assess injuries to the testicles by physical examination and ultrasound.

If the testicles seem normal, the doctor may prescribe pain-relieving medication.

testicular trauma

Even without an ultrasound, a surgeon may choose to explore the testicle, particularly in cases of possible testicular torsion. Surgery is usually performed under a general anaesthetic. Significant injury to the testicles may require surgical exploration and repair or, potentially, removal of the affected testis. The following content is displayed as Tabs.

testicular trauma

Once you have activated a link navigate to the end of the list to view its associated content.Testicular trauma is defined as any injury sustained by the testicle. Trauma to the testicle or scrotum can harm any of its contents.

Such injuries are typically seen in males aged years.

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Testicular trauma is relatively uncommon. Acute scrotal swelling in children is often associated with testicular torsion, testicular rupture, hernia, epididymitis and direct testicular trauma 2. Testicular torsion is when the testicle twists around, cutting off its blood supply.

Occasionally torsion is brought on by a serious trauma to the testicles or strenuous activity. Testicular torsion is an emergency.

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Doctors sometimes fix a testicular torsion manually by untwisting the testicle. The first sign of trauma to the testicle or scrotum is most often severe pain. Because the epididymis has a very thin wall, it easily becomes red and swollen by infection or injury. If not treated, in rare cases the blood supply to the testicle can get blocked.

This can lead to loss of the testicle.

Testicular trauma

Men who suffer more than a minor injury to the scrotum should seek care by a urologist. Reasons to seek medical care are:. Though not linked to the injury, a large number of testicular tumors are found after minor injuries when men are more likely to carefully check their testicles. Testicular cancer caught early can often be cured. But tumors found late often need drawn-out treatment with surgery, radiation, and chemotherapy.

Therefore, a thorough history and detailed physical examination are essential for an accurate diagnosis 4. Scrotal ultrasonography with Doppler flow evaluation is particularly helpful in determining the nature and extent of the injury. This is especially true in blunt trauma cases, given the difficulty of scrotal examination and the repercussions of missing a testicular rupture.

The sensitivity and specificity of ultrasonography in this situation has been reported to be However, in the setting of a clinically apparent hematocele blood in the tunica vaginalissome authors question the value of a ultrasonographic examination and feel prompt exploration is more appropriate 5.

Penetrating testicular trauma usually requires scrotal exploration to determine the severity of testicular injury, to assess the structural integrity of the testis, and to control intrascrotal hemorrhage.

If the tunica albuginea is violated, early surgical exploration, debridement, and closure of the tunica albuginea are necessary. Blunt injuries are encountered more often than penetrating injuries and are usually unilateral, whereas penetrating injuries involve both testes in a third of cases.


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