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Renal and testis injuries in team sports
Irene M McAleer1, George W Kaplan, Barry E LoSasso
1Urology Department, Children's Hospital and Health Center, San Diego, CA, USA.
Purpose:
Children with a solitary testis or kidney are generally advised against contact team sport participation to protect the solitary organ. We performed a review of renal and testis injury cases to ascertain if there was an increased likelihood of significant renal or testis injury in team sports.
Materials And Methods:
We retrospectively reviewed charts on patients evaluated and/or admitted to the trauma service with renal or testis injuries. Severity, outcome and external cause of injury were evaluated as well as patient demographics. Patients were excluded from study if there was no radiographic or physical (postmortem or surgical) evidence of injury. Trauma admission/registry data from all patients enrolled were used for comparison.
Results:
Of 14,763 patients enrolled in the trauma registry from July 1984 until December 2000, 450 (3%) were given a renal or testis injury diagnosis by the registry but only 209 patients (1.4%) met the review criteria for documentation of injury. There were 193 renal injuries (92.3%) and 16 testis injuries (7.7%). A total of 113 injuries were sustained during a recreational or team sport activity (54.1%) and only 10 renal (6) or testis (4) injuries recorded were sustained in team sports (4.8%). Overall team sports injuries recorded in the trauma registry for the study period was 3.4%. No team sports injured patient had a solitary testis or kidney and 1 patient had congenital ureteropelvic junction obstruction. There were only 3 associated injuries (spleen 2, skeletal 1) in the 10 patients. Surgical exploration was performed in all 4 testis injury cases, acute repair of renal injury was done in 1 and delayed pyeloplasty was performed for congenital ureteropelvic junction obstruction. No organs were lost and all patients recovered uneventfully.
Conclusions:
Renal and testis injuries occur with team sports, although at a much lower rate than from other external causes of injury. Most patients ultimately do well without loss of the injured organ. Recommendations against team sport participation may not be necessary in patients with a solitary kidney or testis.