Lower male genitourinary trauma: a pictorial review

Abstract

Blunt and penetrating trauma to the male pelvis and external genitalia may result in significant injury to the lower genitourinary system including the bladder, urethra, penis, and scrotum. Emergent imaging plays an important role in identifying these injuries and directing appropriate, timely management. In this article, we review indications for dedicated genitourinary system imaging in trauma and illustrate the imaging features of injuries to the lower male genitourinary system in order to facilitate accurate and rapid diagnosis.

Imaging of Acute Conditions of the Perineum

“…US is the imaging modality of choice for evaluation of testicular trauma, with reported sensitivity of 100% and specificity of 93.5% for detecting testicular rupture (78). The most common finding of testicular injury is a hematocele, which occurs when there is hemorrhage into the space between the parietal and visceral layers of the tunica vaginalis and is seen as a complex fluid collection (79). Acute intratesticular hematomas can have a heterogeneous echotexture or may be isoechoic (79).…”

“…The most common finding of testicular injury is a hematocele, which occurs when there is hemorrhage into the space between the parietal and visceral layers of the tunica vaginalis and is seen as a complex fluid collection (79). Acute intratesticular hematomas can have a heterogeneous echotexture or may be isoechoic (79). Heterogeneous echotexture of the testicle that corresponds to an area of contusion or infarction and loss of normal contour are fairly sensitive and specific findings of testicular rupture and should raise suspicion (78).…”

“…Patients present with a history of a cracking sound and penile pain, with associated swelling and ecchymosis. A typical penile injury manifests as disruption of the tunica albuginea in one of the corpora cavernosa (79). Surgical exploration usually is performed for penetrating trauma (81).…”

“…US is the imaging modality of choice for initial evaluation of penile injury (79). The tunica albuginea is seen as a thin echogenic line, and a disruption of the tunica albuginea is a key finding of penile rupture (Fig 19).…”

Current Approachs to Urogenital System Injuries in High Energy Trauma Exposed

“…Üretral yaralanma erkek üretrasının daha uzun olması nedeniyle erkeklerde daha sık görülür. Erkeklerde üretra ürogenital diyafram seviyesinde ön ve arka olarak ikiye ayrılmıştır (51) .…”