Traumatic dislocation of the testicle

Abstract

A 35-year-old man was admitted following a road traffic accident during which he had been thrown from his motorcycle. On admission there was pelvic pain on compression associated with oedema and gross bruising of the perineum. This was noted by three different clinicians, one of whom were able to detect any testicular abnormality. Radiographs confirmed separation of the symphysis pubis and disruption of the left sacroiliac joint. He was treated initially by resuscitation and bed rest. Nine days later, after resolution of a paralytic ileus, a Hoffman-Day frame external fixator was applied to treat the pelvic injury. He made a good recovery and was discharged 1 week later mobilizing touch weight bearing with crutches. He was readmitted 5 weeks later for removal of the external fixator and at this stage complained of pain in the groin associated with absence of the right testicle, which was confirmed by clinical examination. He was referred to a consultant urologist and shortly afterwards was admitted for exploration of the right inguinal region. At operation an apparenly normal testicle was discovered adjacent to the superficial inguinal ring and routine orchidopexy was carried out. Pain had begun to diminish within 24 h postoperatively and had resolved completely within I week.