Traumatic Testicular Dislocation Research Articles

Traumatic Testicular Dislocation in Patients With Anterior Pelvic Injuries

Traumatic testicular dislocation can be easily missed, especially against the background of obvious severe injuries in a patient with multiple and concomitant trauma. Despite the fact that traumatic testicular dislocation is a rare condition and does not pose an immediate threat to patient safety, it can cause serious consequences leading to male infertility. To prevent complications, this pathology should be diagnosed and treated as soon as possible. For this purpose, it is necessary to exercise diagnostic vigilance and conduct an appropriate examination in patients with polytrauma, especially those received while riding a motorcycle. The diagnosis of the trauma can be made if, on physical examination, there is a dense elastic formation corresponding to a displaced testicle with simultaneous desolation of half of the scrotum. This will help speed up the diagnosis and initiation of treatment, as well as facilitate preoperative planning of interventions on the bones of the anterior pelvic ring. Therefore, diagnostic instrumental and physical examination with palpation of both testicles upon admission is highly recommended.

Traumatic testicular dislocation. A case report

Traumatic testicular dislocation. A case report

Man With Groin Pain

A 19-year-old male patient was transferred to the emergency department after a motorcycle accident. His main complaint was pain in the left groin and scrotum. He was hemodynamically stable and had a firm, movable, and tender mass over the left groin (Video E1 [available at http://www.annemergmed.com]). The testis in the left scrotum could not be palpated (Figure 1). The emergency physician performed ultrasonography that revealed normal echotexture of testis without hematoma or focal lesions (Figure 2) and confirmed the diagnosis by computed tomography (Figure 3).Figure 2Sonography of the left groin mass in the sagittal plane showed ovoid and homogeneous echogenicity, which favor a normal testis image.View Large Image Figure ViewerDownload Hi-res image Download (PPT)Figure 3Computed tomography image of the abdomen and pelvis in the axial view with intravenous contrast demonstrating dislocation of the testis over the left inguinal region.View Large Image Figure ViewerDownload Hi-res image Download (PPT) Traumatic testicular dislocation. The patient underwent a successful manual testicular reduction in the emergency department. Unfortunately, the testicle redislocated easily, and a urologist performed successful surgical exploration and orchiopexy. Traumatic testicular dislocation is a rare complication of scrotal trauma, typically resulting from straddle injury sustained in a motorcycle collision. The most common dislocation site is the superficial inguinal region, accounting for >50% of cases. Successful manual reduction includes normal scrotal anatomic positioning and immediate pain relief. However, this may only be possible in 15% of cases given the small size of the defect in spermatic cord layers, edema of the scrotal wall, and the possibility of further testicular damage.1Tai Y.S. Chen Y. Tsai P. et al.Traumatic testicular dislocation: a rare occurrence of blunt scrotal injury.Urol Sci. 2014; 25: 158-160Abstract Full Text Full Text PDF Scopus (4) Google Scholar Surgical repair is required if manual reduction fails or there are coexisting injuries.2Subramaniam S. Ab Khalil M.K. Zakaria J. et al.Managing traumatic testicular dislocations: what we know after two centuries.BMJ Case Rep. 2020; 13e236801Crossref Scopus (3) Google Scholar,3Riaza Montes M. Palacios Ramos J. Gallego Sánchez J.A. Testicular dislocation: an atypical case and review of the literature.Urol Case Rep. 2020; 33: 101405Crossref PubMed Scopus (2) Google Scholar https://www.annemergmed.com/cms/asset/bd128463-f101-4c82-8a09-caa0deea2109/mmc1.mp4Loading ... Download .mp4 (2.74 MB) Help with .mp4 files Video E1

Inguinal Hernia Complicated by Traumatic Testicular Dislocation in an Adult—A Case Report—

Inguinal Hernia Complicated by Traumatic Testicular Dislocation in an Adult—A Case Report—

Traumatic testicular dislocation – A case report

We report a motorcyclist who presented with a case of empty scrotum and bilateral dislocated testes in the groin after a blunt scrotal injury. Ultrasound and computed tomography revealed viable testes. Manual reduction was performed with success under anesthesia following orchidopexy. The patient made an uneventful recovery.

Conservative management of bilateral traumatic testicular dislocation in a 10-year-old boy

A 10-year-old boy fell from a one-meter-high Jacuzzi ladder in a hot spring facility, landing in a straddle position, and injured his perineum. He visited the emergency room of our hospital immediately after the injury. Magnetic resonance imaging (MRI) revealed a tear of the corpus spongiosum urethra, and compression due to a hematoma. With the hematoma spreading to the scrotum, the testes became inverted and dislocated to the inguinal region on both sides. Without surgery or interventions, the testes descended into the scrotum on the third day after the injury before fibrillation and scarring began. Testicular dislocation by injury is rare and encountered exclusively in children. It is generally treated with surgery to retain testicular function. We selected conservative management, as our patient had a closed injury without testicular torsion, and the testicular dislocation was associated with compression by hematoma, which could possibly recover with regression of the hematoma.

Traumatic Testicular Dislocation with Torsion: A Case of ‘Dual Trouble Testis’

Traumatic Testicular Dislocation with Torsion: A Case of ‘Dual Trouble Testis’

Traumatic Testicular Dislocation Associated with Lateral Compression Pelvic Ring Injury and T-Shaped Acetabulum Fracture.

We report a case of a unilateral testicular dislocation to the superficial inguinal region associated with a lateral compression type pelvic ring injury (OTA classification 61-C3.3a2, b2, c3) and left T-shaped acetabulum fracture (OTA classification 62-B2) in a 44-year-old male who was in a motorcycle accident. The testicular dislocation was noted during the emergency department primary survey, and its location and viability were verified with ultrasound. The testicle was isolated during surgical stabilization of the left acetabulum through a Pfannenstiel incision and modified-Stoppa approach and returned through the inguinal canal to the scrotum. In follow-up, the patient did not suffer urologic or sexual dysfunction. All motorcycle collision patients presenting with pelvic ring injuries or acetabulum fractures should be worked up for possible testicular dislocation with a scrotal exam. Advanced imaging and a urologic consult may be necessary to detect and treat these injuries.

AB149. Opportunity selection of surgery for traumatic testicular dislocation: elective operation or emergency operation?

ObjectiveTraumatic testicular dislocation is a rare entity. When to take surgical treatment for patients with blunt trauma is still controversial. This study is intended to investigate the surgical timing for closed traumatic testicular dislocation.MethodsA review of the database of Urological Department, Peking University First Hospital was performed searching for traumatic testicular dislocation between Jan 1993 to Jul 2015 and the relevant literature was reviewed.ResultsFive cases of traumatic testicular dislocation were identified, with three on the left side and two on the right side. Diagnosis was suspected with the physical examination and confirmed by Doppler ultrasound. Two cases were operated shortly after trauma and three patients were operated 3-12 months later with assessing the viability of the testis by color Doppler imaging. All patients’ testicles were reserved. The testicular volume and blood flow were normal during a follow-up period for 6-36 months.ConclusionsElective operation can be chosen for closed traumatic testicular dislocation if the Doppler ultrasound confirmed the normal morphology and blood supply of injured testicles. With proper management, the prognosis of traumatic testicular dislocation is excellent.

Traumatic testicular dislocation.

Traumatic testicular dislocation is a rare entity. It occurs after a direct blunt scrotal trauma causing the testicle to migrate outside the scrotum, most frequently to the superficial inguinal region. A review of the diagnostic database of our two institutions was performed searching for complex genital trauma between 1990 and 2012. Seven cases of traumatic testicular dislocation were identified (four on the left side; one on the right side and two bilateral) for a total of nine testicles. Six were motorcycle accidents, and the other case suffered a pelvic crush injury. All victims had significant associated injuries, one case had an open dislocation and two were killed by the accident. The testicle was located at the inguinal region in four cases at the suprapubic area in four, and the other was an open dislocation. Diagnosis was suspected with the physical examination and confirmed by Doppler ultrasound; however, in one case, the diagnosis was missed during several weeks. In one case, the testicle was reduced into the scrotum immediately at the emergency department. Two cases were operated shortly after admission, performing testicular reduction into the scrotum and standard orchidopexy. Two other cases underwent delayed intervention, and both needed release of peri-testicular adhesions. Two cases (both bilateral) died at the accident site and were diagnosed by autopsy. In all surviving cases, it was possible to obtain a satisfactory orchidopexy with gonadal preservation. Traumatic testicular dislocation is rare and diagnosis can be elusive. It should be suspected in motorcycle and high-energy accidents around the groin area and depends on a careful physical examination. With proper management, prognosis is excellent.

Traumatic testicular dislocation: A rare occurrence of blunt scrotal injury

We report a motorcyclist who presented with a right empty hemiscrotum with ecchymosis and swelling after sustaining straddle injuries in a motorcycle collision. A tender soft mass was palpable in the right groin on physical examination. The ultrasound image revealed a right dislocated testis within the inguinal canal; it had a normal size and echotexture. Manual reduction was unsuccessful. The patient underwent surgical exploration and reduction. He recovered well after undergoing orchidopexy. Two weeks later, the follow-up physical examination at the outpatient clinic was normal. Traumatic testicular dislocation is a rare occurrence after blunt scrotal trauma and is easily overlooked. Manual reduction of a dislocated testis has a low success rate and may overlook coexisting injuries. Early surgical exploration and testicular repositioning are necessary to preserve the testis and avoid coexisting injuries.

Traumatic Testicular Dislocation after Minor Trauma in a Pediatric Patient

BackgroundTraumatic dislocation of the testicle is a rare injury that may result from blunt abdominopelvic trauma. The majority of cases reportedly occur in young adults secondary to severe scrotal trauma during high-speed motorcycle crashes. Our review of the available English medical literature revealed only one pediatric case. ObjectiveWe present a case of pediatric testicular dislocation and torsion resulting from minor abdominopelvic trauma. The case report is followed by a brief review of the available literature. Case ReportA 10-year-old boy presented to the Pediatric Emergency Department with abdominal pain. He had suffered a strike to the abdomen and groin during an attempt at flipping over a “monkey bar” at school. A tender mass was found in his right inguinal canal and the genital examination revealed an empty right hemiscrotum. Bedside ultrasonography was used to locate the testicle and it was noted by color-flow Doppler to lack demonstrable blood flow. The patient was taken emergently to the operating room, where he underwent orchiopexy and hernia repair after a viable testicle was found. He had a subsequently uneventful recovery. ConclusionAlthough rare, testicular dislocation may be a serious result of abdominopelvic trauma. Emergency providers who care for trauma patients must include this condition in their differential diagnosis; to do otherwise risks a delay in diagnosis that may affect testicular viability. In this case, testicular dislocation may have resulted from the combination of trauma and a previously undiagnosed indirect inguinal hernia.

Traumatic Bilateral Testicular Dislocation Associated With an Anterior Posterior Compression Fracture of the Pelvis: A Case Report

Traumatic dislocation of a single testicle is an exceedingly rare event and bilateral dislocation is even less common. Traumatic testicular dislocation occurs by the mechanism of direct pressure exerted on the scrotum. Motorcycle collisions are the most frequent causative mechanism, usually related to deceleration straddle injuries. Since traumatic testicular dislocation is associated with other severe injuries, it is usually a late finding, leading to delayed diagnosis and treatment. This report describes a rare case of a patient involved in a motorcycle crash who sustained bilateral testicular dislocation associated with an anterior posterior compression pelvic fracture. To date, there are no reported cases involving management of bilateral testicular dislocation discovered during open reduction and internal fixation of the pelvis. Because the orthopaedic traumatologist may be the first to assess patients with pelvic fracture requiring surgery, the authors feel it is important to raise awareness of this injury.

Bilateral Traumatic Testicular Dislocation

We report on bilateral traumatic testicular dislocation with pelvic injury. Both testes were dislocated in the superficial perineal region and 1 of 2 testes had prolapsed at the perineal region. To our knowledge, this type of bilateral traumatic testicular dislocation has not been previously described.

Traumatic ectopic dislocation of testis.

Traumatic ectopic dislocation of testis is a rare occurrence and usually occurs following a motorcycle collision, in what is referred to as “fuel tank injury”. Early identification and subsequent surgical management is of utmost importance to maintain normal spermatogenesis in the dislocated testis. In appropriate clinical setting, scrotal ultrasound examination with gray-scale and color flow Doppler imaging is the method of choice for diagnosis. Computed tomography of the abdomen is a useful adjunct procedure. We report a case of traumatic testicular dislocation with partial testicular torsion following a motorcycle collision, diagnosed with imaging, and subsequently confirmed on surgery.

Traumatic testicular dislocation: A case report and literature review

Traumatic testicular dislocation: A case report and literature review

Traumatic testicular dislocation: A reminder for the unwary

Traumatic testicular dislocation: A reminder for the unwary

A two-rider motorcycle accident involving injuries around groin area in both the driver and the passenger

This paper presents a two-rider motorcycle accident in which both riders received injuries around the groin area. In medico-legal autopsies, injuries around the groin area in victims of motorcycle accidents are usually regarded as a “fuel tank injury.” Although fuel tank injuries are one of the most useful and important characteristics in determining injuries that have been found to be exclusive to the driver, our study reveals that passengers can also suffer from injuries around the groin area. To distinguish the driver from the passenger, we need to carefully consider each injury in both riders. In addition, we present bilateral traumatic testicular dislocation in the driver. We consider traumatic testicular dislocation as one of the important findings of fuel tank injuries in motorcycle accidents.

Traumatic dislocation of testis

Traumatic dislocation of testis occurs as a consequence of high velocity road traffic accident. We report traumatic testicular dislocation in a young man which was successfully treated with closed reduction under general anesthesia.

RESTORATION OF SPERMATOGENESIS BY ORCHIOPEXY 13 YEARS AFTER BILATERAL TRAUMATIC TESTICULAR DISLOCATION

Traumatic dislocation of the testis represents a condition similar to cryptorchidism in that abnormality of location provides higher temperature to the testis. Histological studies of dislocated testes have revealed degeneration of the seminiferous tubules and absence of sperm formation.1, 2 Hayami et al reported gradual recovery of spermatogenesis after surgical reduction of a dislocated testis.1 We report a case of azoospermia associated with bilateral traumatic testicular dislocation in which sperm production was restored by orchiopexy 13 years after the causative motor vehicle accident.