[The classification, diagnosis and treatment of closed injuries to the scrotum and testis]

Clinical and intraoperative evidences of closed scrotal and testicular injuries were correlated in 119 out of 171 treated patients. On the basis of clinical and anatomical signs the authors developed the classification of the aforementioned injuries distinguishing between the isolated scrotal and testicular ones. In 80.9 per cent of the patients operated on for the testicular injuries the patterns of the trauma were identified as the ruptures, contusions, or intratesticular hematomas. With regard to the clinical signs the classification permitted one to diagnose isolated injuries of the scrotum, the ruptures of the testis or intratesticular hematomas. Regardless of the extent of the trauma (testicular ruptures or intratesticular hematomas) histological studies revealed hemorrhagic infiltrations, vascular thromboses and dystrophic changes of the tubular epithelium only in the hours immediately after the accident. The authors documented the early development of suppuration and sclerosis of the compromised organ. The conservative treatment was found to be advisable only for the patients with isolated scrotal injuries and small hematomas in tunica dartos. Large hematomas in tunica dartos, testicular ruptures or intratesticular hematomas necessitated the performance of emergency organ-sparing surgeries with the use of anticoagulants, antibiotics and anti-inflammatory drugs. The above treatment policy was a success in 65 per cent of these treated.