Trauma to male genital organs: a 10‐year review of 156 patients, including 118 treated by surgery

Abstract

OBJECTIVE To assess testicular rupture, scrotal haematoma, penile fracture and penile injury, comparing the prognoses of surgery and conservative management, as trauma to male external genital organs can cause devastating effects on patients and their partners. PATIENTS AND METHODS We reviewed the medical records of 156 male patients who presented to our emergency centre with trauma to the external genital organs between January 1996 and March 2006. RESULTS In all, 74 patients had testicular rupture, 32 penile fracture, 26 a penile injury and 24 a scrotal haematoma (mean age 27.8 years). The main cause of trauma was assault (52, 33%). Four of 14 patients with penile trauma who were managed conservatively had complications. Of 20 patients, 17 had a partial orchidectomy and were followed for a month after surgery; scrotal ultrasonography showed three cases of testicular atrophy. The mean hospital stay was less for patients with surgical intervention, at 6.4 days, than for those managed conservatively, at 8.7 days (P < 0.05). A visual analogue pain scale showed less pain in patients who were surgically treated (P < 0.05). CONCLUSION Prompt surgical intervention is crucial; it should be considered by urologists, and is strongly recommended. Ultrasonography was highly sensitive and specific, and should be used in all patients with trauma to the external genital organs, to aid diagnosis and evaluation before surgery.

Male External Genital Injuries; Pattern of Presentation and Management at the Jos University Teaching Hospital

“…These have been documented by different studies. Lee et al, in a 10 years review of patients with trauma to the male genital organ, recorded a mean age of 27.8 years [9] while Ahmed et al recorded a mean age of 28(±3.2) [10]. In this study the mean age was 30.6 years which is similar to the findings of other investigators.…”

“…Because trauma is predominantly a disease of young persons, genital injuries may profoundly affect health-related quality of life and contribute to the burden of disease related to trauma [8], [9].…”

Our Results in Penile Fractures

“…Penile fractures present with major complications, such as penile deformity, painful erection, challenged coitus, poor erection quality, and pseudodiverticula. Such complications have been reported in the range of 10-30% particularly in the conservatively treated patients whereas the same remains between 0 and 10% in the surgically treated cases (17,18,19,20). No complication has been reported in our patient group.…”

Inguinoscrotal pathology

“…Ultrasound is the best imaging test for assessment of testicular trauma and may show parenchymal fracture or 19 Management depends on the severity and type of trauma. Over the last two decades, we have seen a change in the management of blunt testicular trauma, with less surgical exploration and a more conservative approach.…”