Accuracy of ultrasound diagnosis after blunt testicular trauma

The aim of this study is to determine the value of ultrasound evaluation for the diagnosis of testis rupture due to blunt scrotal trauma. We reviewed 16 operated cases of blunt scrotal trauma with hematocele, which were evaluated by ultrasound preoperatively. In 2 cases a tunica albuginea rupture was correctly diagnosed by ultrasonography but there were 2 false-positive and 5 false-negative diagnoses of rupture. Systematic exploration of the 16 cases revealed testicular rupture in 7, simple hematocele in 7 and hematocele associated with spermatic cord injury in 2. In 2 cases orchiectomy was necessary. From our experience the accuracy rate of ultrasound evaluation of blunt scrotal trauma was 56%, with a 58% negative predictive value. Considering these results, ultrasound examination of blunt scrotal trauma with hematocele is not sufficiently accurate to eliminate surgical exploration and, therefore, we recommended early surgical exploration as primary therapy in these cases.