Rupture of Testicular Tunica Albuginea: A Urological Emergency

Abstract

Background: Road traffic accident, commonly enunciated as “RTA”, is the leading cause of morbidity and mortality worldwide. However, for a urologist, an “RTA” could imply “Rupture of the testicular Tunica Albuginea”, with equivalent, if not higher psychosocial, anatomical and hormonal morbidity and/or mortality. Blunt or penetrating trauma, or degloving injuries, may lead to an RTA, with extrusion of the testicular seminiferous tubules, mandating an early diagnosis and prompt intervention, in order to prevent future complications. Method: A thorough “pubmed” search was conducted with the terms “testicular rupture” and “tunica albuginea rupture”, and all English language articles with these terms in title or abstract, were included in this review. Results/ Conclusion: The following review highlights this urological emergency as an important differential for an “acute scrotum” and provides an insight into the currently available literature documenting testicular ruptures, as well as the various diagnostic modalities and management practices. Additional food for thought remains the need for long term follow up of these patients, in order to assess for hypogonadism or infertility as well as the need to understand the role of the “blood-testis barrier” and possible implications of its breach, with auto antibody production.

Post-traumatic Ruptured Scrotal Collection: Pyocele or Hematocele?

“…Pyocele can be managed conservatively by fluid resuscitation, pain management, and empirical antibiotics [ 5 ]. However, immediate surgical exploration, debridement, and removal of the devitalized testicular tissue with the closure of the ruptured membranes form the mainstay of the treatment [ 11 ].…”