Pd02-02 Effect of Intratesticular Hematoma on Testis Microstructure, Spermatogenesis and Testosterone Production: Determining a Cut-Off Point for Significant Intratesticular Hematoma in an Experimental Blunt Testis Trauma Model

Abstract

management based on hospital trauma level designation, and analyze management trends over time.METHODS: This retrospective cohort study included renal trauma from the National Trauma Data Bank 2010-2015. We examined the association between hospital trauma level designation (level I vs transferred to level I vs non-level I), and renal trauma management including nephrectomy, angioembolization, and nonoperative management, along with presence of any annual linear time trends in management.RESULTS: We analyzed 51,798 renal trauma records; 44,838 low grade (AAST I-III) and 6,359 high grade (IV-V) injuries. After adjusting for comorbidities, demographics, and hospital characteristics, odds of nephrectomy, angioembolization, and nonoperative management were similar in patients transferred to a level I and directly admitted to level I centers, compared to those treated at non-level I for both high and low grade injuries (Table 1), although mortality was lower in those transferred to level I centers (OR 0.70, 95% Cl 0.61-0.80, p<0.001). Change over time of management of high grade renal injuries demonstrated a decrease in the use of nephrectomy (p¼0.007) while rates of angioembolization remained constant (p¼0.33) (Figure 1).CONCLUSIONS: In this contemporary trauma analysis, outcomes of both low and high grade renal trauma are similar across those patients managed in tiered trauma centers, signifying dissemination of collective renal trauma management. The rate of nephrectomy has decreased for high grade renal injury over our study period suggesting new adoption of kidney sparing management.