Male Genital Injuries Research Articles

Injuries to the male external genitalia in the material of the Department of Urology of the Military Institute of Medicine – National Research Institute, using the AAST trauma scale

Introduction and objective: Injuries to male external genitalia account for 2% of all injuries. Most affected patients require surgical intervention. This study aimed to retrospectively analyse the diagnosis and treatment of male external genital injuries using the American Association for the Surgery of Trauma (AAST) scale to assess their severity. Materials and methods: A total of 998 men with abdominal and pelvic injuries were admitted to the Emergency Department of the Military Institute of Medicine – National Research Institute in Warsaw, Poland, between October 2017 and August 2022. Injuries to male external genital organs were identified in 26 patients (3%). The mean age of this group was 37 years (21 to 72 years). Direct trauma to external genital organs was diagnosed in 14 patients (54%). In 12 patients (46%), external genital trauma was an accompanying injury to multi-organ injuries resulting from traffic accidents or falls from heights. All patients underwent a detailed history taking and physical examination, as well as ultrasound and/or trauma scan, followed by AAST. Results: In the group of 26 patients with external genital trauma, 14 patients (54%) were classified for urgent surgical treatment, including 8 patients (31%) with penile fractures and 6 patients (23%) with scrotal and testicular injuries. In one case, penile fracture was accompanied by urethral damage. In another case, orchidectomy was necessary in the group of patients with scrotal injuries. Among the 12 patients (46%) with multi-organ injuries following traffic accidents or falls from heights, bed regimen and antibiotic therapy allowed full recovery. According to the AAST scale for penile, scrotal, and testicular injuries, grade I was observed in 14 patients, grade II in 6 patients, grade III in 5 patients, grade IV in 3 patients, and grade V in 1 patient. Conclusions: The AAST scale is an effective and practical tool for assessing injuries to the male external genitalia. Early diagnosis and surgical treatment of male genital injuries reduce the risk of complications, whereas delayed diagnosis and treatment may result in infection and reproductive dysfunction.

Penetrating trauma to scrotum and penis caused by a gunshot in 17-year old man: A case report

Penetrating trauma to male external genitalia is a rare trauma case. It accounts for 20% of all genitourinary trauma cases, and penile involvements are presented between 10- 16% of all cases. Male genital trauma is considered a urological emergency due to the high risk of infection, sexual dysfunction, and infertility. In this work, a 17-year-old male patient presented with scrotal and penile injuries due to a low-velocity gunshot wound. Genital examination revealed tissue loss in the foreskin, glans, anterior urethra (distal third), cavernous corpora, and total loss of right testis with a scrotal laceration. The patient was treated with partial penectomy, penile reconstruction, and urethral repair with an excellent uneventful postoperative cosmetic and functional outcome. In conclusion, penetrating male external genital injuries are rare with extremely serious consequences due to the functional, psychological, and aesthetic consequences. The best treatment with penile reconstruction and urethral and cavernous corpora repair may be achieved.

Male genital injuries treated at a tertiary hospital in the western region of Nepal: A two-year snapshot.

Background: Male genital injuries are urological emergencies which if not promptly treated with correct therapeutic intervention may lead to loss of fertility due to infections and anatomical disruption of normalcy. This study highlights the clinical scenarios, etiology and outcome of male genital injury cases that were managed at a tertiary care center in Nepal. Such injuries are not frequently encountered as patients are hesitant to report such injuries. The present study is the first from Nepal which depicts a comprehensive report on male genital injuries. Methods: A retrospective analysis of discharge summaries of the cases of male genital injuries was reviewed during June 2020. All the treated cases during the two-year period from April 2018 to April 2020 at Lumbini Medical College, Nepal were included in the study. Results: There were eight cases of genital trauma admitted and treated during the study period. All the patients were males and age ranged from six to 71 years with a mean age of 33 ± 21.45 years. Fall injury and road traffic accidents (RTA) were observed to be the primary cause in the majority of cases. Conclusion: Superficial injuries to the penis and scrotum do not require surgical exploration and could be managed conservatively. However, deeper and complicated injuries, testicular preservation, the functionality of the part and cosmetic issues are taken into consideration which might require a multi-disciplinary approach. Apart from the medical issues pertaining to genital injuries, there are legal and psychological aspects of such events too which should not be ignored.

Male genital injuriesattending a tertiary hospital inawestern region of Nepal:Atwo-year snapshot.

Male genital injuries are urological emergencies which if not promptly treated with correct therapeutic interventionmaylead to chances of loss of fertility due to infections and anatomical disruption of normalcy.This study highlights the clinical scenarios, etiology and outcome of malegenitalinjury cases that were managed at a tertiary care center in Nepal.Such injuriesare not frequently encounteredaslack of reportingbypatients means cases are rare.The present study isthefirst from Nepal which depicts a comprehensive report on male genital injuries. Methods:A retrospective analysis of discharge summarieswas carried out and the cases of male genital injuries were reviewed duringJune2020. All the treatedcasesduring thetwo-yearperiod from April 2018 to April 2020at Lumbini Medical College, Nepalwere included in the study. Results:There wereeightcases ofgenitaltrauma admitted and treated during the study period. All thepatients weremales and age ranged fromsixto 71 years with a mean age of33±21.45years. Fall injury and road traffic accidents (RTA) were observed to be the primary cause inthemajority of cases. Conclusion:Superficial injuriestothepenis and scrotum do not require surgical exploration and could be managed conservatively. However,deeperand complicated injuries, testicular preservation, the functionality of the partandcosmetic issuesaretaken into consideration which might requireamulti-disciplinary approach.Apart from themedical issues pertaining togenital injuries, there arelegal and psychological aspects of such eventstoo which should not beignored.

Degloving Penile Injury with Urethral Avulsion: A Case Report

Accidental male genital injuries represent a serious urological disorder that demands immediate urological treatment due to risk of infection and need for fertility preservation. We reported a 30- year-old gentleman who presented with an extensive penile degloving injury, right open pneumothorax and right thigh laceration following a buffalo attack. Examination under anesthesia (EUA) demonstrated ruptured penis with tearing up to penile base and partially avulsed right testis. Right orchidectomy, wound debridement and suprapubic catheter insertion performed before being referred to Penang General Hospital. Repeated EUA revealed avulsed penile urethra 3cm from the meatus with interposing granulation tissue of 2cm in length. He underwent serial wound debridement and eventually required a split skin graft to the penis. Patient was reported to be able to achieve penile erection by 2 months post-operative and planned for urethroplasty later. This is the first paper that reports an incident of buffalo attack resulting in degloving injury of penis. Management depends on severity of trauma and prompt intervention essential to prevent immediate as well as delayed complication. Urethral injury must be considered in any extensive penile injury. Despite multiple modality for traumatic penile skin loss repair, split thickness skin grafting (SSG) was chosen for this patient. Conclusion: External injuries of the genitals, particularly caused by animal attack, should be followed by immediate operative exploration and if necessary, to reparative measures. Care must be taken with goal of optimizing long term sexual, cosmetic and voiding outcomes.

The Management of Pediatric Genital Injuries at a Pediatric Emergency Department in Japan.

Genital injuries among children are often associated with consumer products or specific activities. There are few descriptive studies from Asia on pediatric genital injuries seen in the emergency department (ED). The aim of this study was to describe the characteristic features of accidental genital injuries among children. A retrospective chart review of children aged 15 years or younger who visited our ED for genital injuries between March 2010 and November 2014 was conducted. Data on age, arrival time at the ED, location of the incident, mechanism of injury, objects, injured organ, consultation with specialists, emergency operation, sedation at the ED, and outcomes were collected and analyzed. One hundred seventy-nine patients were included in this analysis. Girls comprised 71% of the subject pool. The median age was 6 years (interquartile range, 4-9 years). Straddle injuries were the most common form of injury (56%). Male genital injuries occurred mostly outdoors (64%). Common consumer products associated with pediatric genital injuries were furniture (21%), exercise equipment (17%), and bicycles (15%). Thirty-two patients were examined by a surgeon, gynecologist, or urologist. The most commonly injured organs were the penis (55%) in boys and the labia (60%) in girls. Most patients (93%) were treated at the ED and discharged. The characteristics of accidental genital injuries among Japanese children were similar to those of children in other countries. The strategy for preventing genital injuries used in the West might be applicable to the East Asian context.

Male External Genital Injuries; Pattern of Presentation and Management at the Jos University Teaching Hospital

Male External Genital Injuries; Pattern of Presentation and Management at the Jos University Teaching Hospital

Male genital injuries caused by ritual attacks in Nigeria: Problems of management

Reports of genital injury and loss from attacks allegedly perpetrated for ritual purposes are often reported in the media and discussed in social circles in Nigeria, but such reports are rare in the medical literature. We report three cases of genital injuries caused by attacks, allegedly for ritual purposes, so as to document the occurrence of such injuries and to stimulate interest in their prevention and medical management. The patterns of presentation and the problems of management in Nigeria are discussed.

Editorial Comment to Clinical outcome analysis of male and female genital burn injuries: A 15‐year experience at a Level‐1 Burn Center

Editorial Comment to Clinical outcome analysis of male and female genital burn injuries: A 15‐year experience at a Level‐1 Burn Center

Clinical outcome analysis of male and female genital burn injuries: A 15‐year experience at a Level‐1 Burn Center

The American Burn Association classifies a burn to the genitalia as a major injury. Isolated burns to the penis, scrotum or vulva are rare as a result of protection provided by the thighs and abdomen. Thus, burned genitalia represent an ominous sign of a more extensive total body surface area burn. A retrospective analysis of consecutive patients admitted to a Level-1 Burn Unit with a burn involving the genitalia from January 1995 to December 2009 comprised the study population. A total of 393 patients of 5878 patients (6.7%) admitted to the Burn Unit suffered a burn involving the genitalia, including 253 males (64.4%) and 140 females (35.6%). The median total body surface area was 12% (range 1-100%), the most common cause of genital burn was scald (n = 246, 62.9%) and median length of stay was 9 days (range 1-472 days). A total of 269 patients (68.4%) were discharged to home from the hospital, and in-hospital mortality was 20.9%. The typical profile for those sustaining a genital burn include younger patients (≤30 years-of-age), sustaining a median total body surface area burn of 12% from a scald injury, with extensive genitalia involvement. Length of stay for genital burns is usually extended and, as a result of concomitant injuries, is associated with a 20% in-hospital death rate.

Analysis of nonsexual injuries of the male genitals in children and adolescents

This study analysed nonsexual male genital injuries in boys with regards to aetiology, age, management and outcome. Patients were identified from the hospital database (between 1999 and 2009) were analysed retrospectively. Seventy-four patients (2-17 years) were identified which included 24 toddlers and small children (2-5 years), 36 school age children (6-12 years) and 14 adolescents (13-17 years). Traumas were related to falls (n=14), kicks (n=11), sport (n=10), toilet seats (n=9), motor vehicles (n=8), bicycle (n=4), outdoor activities (n=4) and others causes (n=14). The leading cause of injuries in (i) toddler and small children was related to toilet seat (n=7) and falls (n=7), (ii) school age children to sport (n=8), kicks (n=7) and falls (n=6), and (iii) adolescents to motorcycle accidents (n=5). There were 45 scrotal and 29 penile injuries ranging from lacerations to contusions. Sixty-eight patients required hospital stay (0.5-36 days, Σ=2.4 days). Follow-up examinations were uneventful, except for one minor wound infection. Nonsexual traumas to the male external genitalia occur mostly in 6- to 12-year-old boys, with sport accidents, kicks and falls being the major causes. Scrotal and penile lacerations and testicular contusions are the most common injuries. Complications after injuries to the male genitals in children are rare.

Äußeres Genitaltrauma

This article reviews the current status of information on external male genital injuries, focusing on the causes as well as diagnostic and therapeutic management of this uncommon entity. Because of the high risk of infection and the major importance of preserving fertility, male genital injuries represent a serious urological disorder that demands immediate urological treatment. The diagnostic procedure classically consists of taking a history and inspecting the wound, which provides enough diagnostic information for the correct choice of conservative or surgical treatment. In most cases open injuries of the genitalia require surgical exploration to determine the extent of possible scrotal, testicular, epididymal, cavernous, or urethral damage, to débride nonviable superficial or deep tissue, to drain existing hematomas, or to control active bleeding. Furthermore, the correct therapeutic approach is crucial for preserving fertility and penile erection. In cases where bilateral ablation is necessary, measures to preserve sperm, e.g., testicular or microsurgical sperm extraction, or squeezing the ductus during orchidectomy must be considered.

Male genital injury: diagnostics and treatment.

This article reviews the current status of information on external male genital injuries, focusing on cause, diagnostic and therapeutic management of this uncommon entity. Because of the high risk of infection and the major importance of preserving fertility, male genital injuries represent a serious urological disorder that demands immediate urological treatment. The diagnostic procedure classically consists of taking a history and inspecting the wound; this provides enough diagnostic information for the correct choice of conservative or surgical treatment. In most cases open injuries of the genitalia require surgical exploration to determine the extent of possible scrotal, testicular, epididymal, cavernosal or urethral damage, to debride nonviable superficial or deep tissue, to drain existing haematomas or to control active bleeding. Furthermore, the correct therapeutic approach is crucial for preserving fertility and penile erection. In cases where bilateral ablation is necessary, measures to preserve sperm, e.g. testicular or microsurgical sperm extraction, or squeezing the ductus during orchidectomy, must be considered.

Diet and prostate cancer.

There are four mini-reviews in this section, all on different areas of urological interest. Diet and prostate cancer continues to offer areas of clinical and laboratory research for investigation. Not every urologist looks after patients with spinal cord injury, but neuropathic bladder problems caused by other conditions are common. One of the acute conditions in these patients is autonomic dysreflexia, and this is covered here. I am about to introduce a series of papers which will form a consensus on the management of genitourinary trauma, which appears elsewhere in the journal. In this section this month, authors from Germany describe the diagnosis and treatment of male genital injuries. Finally, the concept that the urologists who operate on the largest volume of cases have the best outcomes from a particular operation is examined.

Male genital tract injuries after contemporary inguinal hernia repair.

Male genital tract injuries after contemporary inguinal hernia repair.

Male genital injuries from external trauma.

External trauma from a variety of causes, some unusual and bizarre, affect the male genitalia. Certain injuries are more common, have more severe consequences, or their management may be controversial. Seventy male genital injuries from external trauma are reported and include vacuum cleaner injuries, fracture of penis and the tourniquet syndrome.