Blunt Scrotal Trauma in Soldiers-Epidemiology and Outcome

Blunt scrotal trauma (BST) is common among soldiers but its incidence and outcome are unknown. The purpose of this study was to estimate the incidence, clinical findings, and outcome of BST in soldiers referred to a primary care field physician.

The medical records of soldiers in their military services who sustained BST and were evaluated by primary care field doctors over a 10-year period were reviewed. Anamnestic data, physical findings, primary care physician decisions, hospitalization, and surgery rates as well as final outcomes were analyzed.

The medical records of 382,036 soldiers were reviewed and 668 cases (0.175%) of BST were identified. All patients complained of scrotal pain and 10% of dysuria. The most common physical findings included: scrotal tenderness (71.7%), scrotal edema (16.2%), and scrotal hematoma (4.8%). In 11.8% of the visits microhematuria was found in urine dip stick. A total of 243 patients (36.4%) were referred to emergency department, but only 9 (3.7%) were hospitalized. Of these, 3 patients underwent surgical exploration due to suspected testicular rupture in ultrasonography. Finally, testicular rupture was found only in 1 patient. This testis was sutured. In another patient testicular torsion was found and orchiectomy done. 168 patients (25.1%) developed prolonged scrotal pain lasting for more than 2 weeks after the trauma.

Blunt testicular trauma is not an uncommon phenomenon among soldiers. Surgical intervention is rarely needed and in 99.6% of cases seen by general practitioners supportive management is suffice. The phenomenon of prolonged post-traumatic testicular pain, developing in a quarter of the patients after BST pain deserves more research.