Management of 53 cases of testicular trauma

Fifty-three patients with testicular injury were investigated. Four (8%) had bilateral testicular injury and 15 (28%) had associated injuries, such as penile, spermatic cord, epididymal disruption, thigh, urethral, perineal skin avulsion, femoral vessel disruption and axillary venous injury. The mode of testicle trauma was blunt in 36 (63%) and penetrating in 21 (37%) cases. Early exploration was done in 43 (81%) patients including 4 with bilateral testicular injury: hematoma evacuation in 23 (49%), partial orchiectomy in 16 (34%) and total orchiectomy in 8 (17%) cases, respectively. Otherwise, delayed exploration, due to the late presentation of more than 3 days after trauma, was done in the remaining 10 (19%) patients: hematoma evacuation in 6 (60%) and partial orchiectomy in 4 (40%) cases. The testicle salvage rate was 49/57 (86%), depending on the nature of testicular trauma. Hospitalization for uncomplicated cases was 4.82 +/- 1.85 days, with prolongation to 10.79 +/- 3.64 days (p < 0.05) for patients having associated injuries. Exploration is advocated in all cases of hematocele, irrespective of testicle contusion or rupture. As minimal, the blood-clot from the tunica vaginalis sac should be evacuated, which would relieve disability and hasten recovery.