Intra-Testicular Papaverine Injection for Testicular Salvage after Blunt Testicular Trauma: A Case Report

Abstract

Blunt trauma is the most common mechanism of injury to the scrotum and testicle. Surgical exploration with primary repair, hematoma evacuation, and de-torsion are common surgical interventions. A 20-year-old male with no previous medical history presented after a high-speed motor vehicle collision. Ultrasonography demonstrated heterogeneous changes of the tunica albuginea and decreased arterial flow to bilateral testicles. He was subsequently taken to the operating room for surgical exploration, which revealed bilateral mottled testes with questionable viability. Papaverine was injected into each testicle, which resulted in visibly increased perfusion and subsequent preservation of the testicles. Conclusion: Current evidence on the use of papaverine is isolated to testicular torsion. Additional research should be conducted on the use of papaverine in blunt testicular trauma. Papaverine injection may be a valuable treatment option when inadequate perfusion is observed intra-operatively.

Testicular Rupture: The Other Nutcracker Syndrome

“… 9 A novel technique, as utilized in our case above, involving apposition of the free edges of the tunica vaginalis was reported by Molokwu et al, 8 in which they demonstrated viability and stability in testes size 3 months post-operatively. In a recent case report by Keating et al, 10 they suggest the use of Papaverine as a form of salvage therapy for testicular rupture associated with inadequate perfusion. Papaverine has been utilized in subarachnoid hemorrhage to improve cerebral arterial flow but few studies are available to suggest a role for testicular hypoperfusion and therefore will warrant further investigation.…”

Orchiectomy after testicular trauma in a 45-year-old man: A case report

“…Testicular trauma is a relatively uncommon urological emergency that can lead to significant morbidity if not managed promptly and effectively [ 1 ]. Testicular trauma, although relatively rare, can occur due to various causes such as sports injuries, accidents, or direct blows to the groin region [ 2 ]. In severe cases, where the testicles are extensively damaged and cannot be salvaged, the surgical removal of one or both testicles, known as orchiectomy, may be considered [ 3 ].…”