[Testicular trauma: report of 56 cases]

To assess the diagnostic value of clinical examination and ultrasound in testicular trauma and to analyse the complications of the various treatments proposed (surgical and medical treatments), in order to more clearly define the place of medical treatment in this form of trauma in young adults.

56 cases of testicular trauma in 50 patients were managed between January 1990 and January 2000. In the absence of clinical and ultrasonographic criteria of severity (haematocele, very large intratesticular haematoma, rupture of the tunica albuginea), medical treatment consisting of rest, anti-inflammatory drugs, and testicular support was instituted. Surgical exploration was performed when serious lesions of the testis were suspected. Three subgroup were defined: the medical treatment subgroup, the early surgical treatment subgroup, and the deferred surgical treatment subgroup (more than 3 days after trauma). The immediate morbidity and long-term sequelae were analysed in each of these three subgroups.

The clinical features of pain and scrotal swelling make assessment of the lesions difficult. Testicular ultrasound can help the clinician, but it has a low sensitivity for the diagnosis of testicular rupture. No significant difference was observed between the three subgroups in terms of morbidity, orchidectomy, and long-term sequelae rates.

In the absence of signs of severity, medical treatment with regular surveillance remains justified. However, in the case of doubtful clinical or ultrasound findings, surgical exploration must be performed as soon as possible.