Testicular Doppler ultrasound in scrotal trauma: A diagnostic tool with potentially relevant therapeutic implications

Abstract

Scrotal trauma is one of the rare causes of genital trauma. Although it is not usually fatal, it generates multiple implications in the social and psychological components, impacting the male reproductive and endocrine functions. Blunt trauma is the most frequent scrotal trauma; however, a non-negligible portion is due to penetrating injuries. Its diagnosis has been clinical and its management has been relegated to exploratory surgical interventions, accompanied by a high testicular loss rate. According to this scenario, timely diagnosis and proper treatment become the management pillars of this entity. Although multiple tools have been described to characterize scrotal lesions objectively, testicular Doppler ultrasound can cost-effectively provide relevant information so as to avoid unnecessary surgical interventions.

Bursal Traumas: Epidemiological, Clinical and Therapeutic Aspects

“…The use of Doppler in bursal trauma is reserved for situations in which conventional examination has been noncontributory. Doppler provides information on the integrity of testicular vascularization, and confirms testicular fracture when there is a break in the continuity of a hypoechoic testicular albuginea [4,15]. Moreover, the existence of vascularization in the testicular parenchyma indicates the latter's capacity for functional recovery after the trauma [4].…”

“…Doppler provides information on the integrity of testicular vascularization, and confirms testicular fracture when there is a break in the continuity of a hypoechoic testicular albuginea [4,15]. Moreover, the existence of vascularization in the testicular parenchyma indicates the latter's capacity for functional recovery after the trauma [4]. The use of magnetic resonance imaging (MRI) in bursal trauma is not at all conventional, as it is not an easily obtainable examination and its cost remains high.…”

“…Thanks to advances in medical imaging, watchful abstention has also become a valid therapeutic option, particularly in the case of closed bursal trauma. This abstention most often requires the use of analgesics, bursal suspension and regular ultrasound monitoring [4,17].…”

“…The diagnosis of trauma is most often made on clinical examination by the presence of scrotal pain, ecchymosis or bursal oedema. In the case of blunted trauma, medical imaging exams may be required to assess the lesion [4,5]. For a long time, Surgical exploration has for a long time been systematic as an emergency in the face of any bursal trauma.…”

“…For a long time, Surgical exploration has for a long time been systematic as an emergency in the face of any bursal trauma. Complementary examinations have modified this attitude, with the introduction of watchful abstention in these cases [4,6]. The aim of our work was to analyze the epidemiological, clinical and therapeutic aspects of bursal trauma in our department.…”