How I Manage Testicular Injury

In brief: The pain and swelling that often follow testicular injuries can make it difficult to distinguish a contusion from a severe injury. An accurate diagnosis is imperative because in cases of testicular rupture or intrascrotal bleeding, surgery may be necessary to save the testicle. If scrotal swelling makes examination of the testis difficult, transillumination or ultrasound may help. Aspiration of the scrotum is rarely indicated for diagnostic reasons. A contusion generally can be treated with bed rest and oral analgesics, but a spermatic cord block may be used if the pain is very severe. If testicular rupture cannot be ruled out, prompt urological referral is appropriate.