845 A Case of Testicular Salvage Following Complete Capsular Rupture Due to Direct Trauma During Ju-Jistu

Abstract

Abstract Background Testicular rupture refers to injury of the tunica albuginea and subsequent extrusion of seminiferous tubules. It occurs usually in young men following high impact or sporting injuries. Prompt diagnosis is required, and treatment is time-critical to avoid testicular loss. Clinical scenario A 32-year-old man presented to the emergency department with scrotal pain five hours after a direct blow to the right scrotum whilst doing Ju-Jutisu. Examination revealed a tense, swollen and extremely tender right hemi-scrotum. An urgent testicular ultrasound confirmed a right complete capsular rupture with almost circumferential superior-pole tunical defect. The patient was promptly consented for scrotal exploration +/- right sided orchidectomy. Intra-operatively finding was a complete rupture of the right testes and considerable haematoma. A partial orchidectomy was performed, resecting all devitalised seminiferous tubules while the viable testicle was re-constructed with combined primary apposition of albuginea and a tunica vaginalis flap. The resulting cosmetic appearance was adequate. The patient was discharged home the following day, with antibiotics and his recovery was uncomplicated. At four weeks, the patient reported no further pain and post operative imaging was reassuring. He was pleased to avoid complete orchidectomy. Discussion Clinicians should have a high index of suspicion for testicular rupture following blunt trauma to scrotum. Patients are frequently anxious about loss of testes and the impact on self-image, fertility, and hormonal function. This case demonstrates that prompt urological review and early scrotal exploration can prevent testicular loss.