Title: A Case of Testicular Rupture – A Case Report
Authors: Dr C. P. Mohan. M.S., Dr R. Jayavarmaa. M.S.
DOI: https://dx.doi.org/10.18535/jmscr/v8i1.114
Abstract
Introduction: The classification of testicular trauma is based on etiology into blunt, penetrating and degloving injuries. Blunt testicular trauma is the major cause which occurs due to assault, sports injuries and road traffic accidents typically affecting adult males aged 15–40 years [1]. Most of the blunt trauma manifest as unilateral testicular injury [2].
Case Report: A 26 year old adult male presented with complaints of pain and swelling over right side scrotum for 2 days after sustaining trauma with a cricket ball. The patient had no history of fever, vomiting or any urinary discomfort. The patient’s general physical examination was normal. Vitals were stable. Local examination of the external genitalia revealed tense and tender swelling of the right side scrotum. Both the testes and penis were normal. USG of the scrotum revealed hematoma collected over the right side scrotum. A midline raphe incision was made over the right side scrotum for about 5cm and layers deepened. Tunica vaginalis was opened and about 100ml of clots were evacuated. There was a tear in the tunica albuginea exposing the seminiferous tubules. The tubules were placed back inside and tunica albuginea was closed with vicryl.
Discussion: Most of the testicular ruptures are diagnosed secondary to sports related injuries [3] and RTAs. A delay in care may lead to impaired fertility, hypogonadism and testicular loss [4].In the case of testicular rupture, when exploration is done within 72 hours cure rates are peaking upto 90%. Beyond 72 hours, salvage rates fall drastically to approximately 45% [5].
Conclusion: Early diagnosis and if needed, scrotal exploration are very much necessary for treating testicular injuries. Testicular trauma should be treated appropriately, as timely intervention may prevent the need of orchidectomy.
Keywords: Blunt trauma, Testicular injury, Testicular rupture, Testicular failure, Orchidectomy.