Can Ultrasound Help to Manage Patients with Scrotal Trauma?

Overview

Journal Ultrasound

Date 2016 Jul 20

PMID 27433221

Citations 6

Authors

T Adlan

S J Freeman

Affiliations

Soon will be listed here.

Abstract

Traumatic injuries to the scrotum are uncommon but, when they do occur, frequently lead to serious complications. Early complications include testicular infarction, necrosis and abscess formation; in the longer-term trauma may result in testicular atrophy and subfertility. Early surgical intervention in patients with testicular rupture can significantly improve the clinical outcome and reduce the need for delayed orchidectomy. However, clinical examination of the scrotum following trauma is difficult and frequently inaccurate; this may result in incorrect triage of patients for surgical exploration. Scrotal ultrasound can reliably assess scrotal injuries and diagnose testicular rupture with a high level of accuracy. Additionally, ultrasound can provide important information regarding testicular perfusion, which can further inform decisions on surgical management. This article reviews the sonographic findings that may be encountered in patients with scrotal trauma, with an emphasis on blunt trauma. It describes the pivotal role that ultrasound can play in the accurate triage of these patients to surgical or conservative management.

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References

Kukadia A, Ercole C, Gleich P, Hensleigh H, Pryor J . Testicular trauma: potential impact on reproductive function. J Urol. 1996; 156(5):1643-6. DOI: 10.1016/s0022-5347(01)65472-7. View

Deurdulian C, Mittelstaedt C, Chong W, Fielding J . US of acute scrotal trauma: optimal technique, imaging findings, and management. Radiographics. 2007; 27(2):357-69. DOI: 10.1148/rg.272065117. View

Mitterberger M, Pinggera G, Neuwirt H, Colleselli D, Pelzer A, Bartsch G . Do mountain bikers have a higher risk of scrotal disorders than on-road cyclists?. Clin J Sport Med. 2008; 18(1):49-54. DOI: 10.1097/JSM.0b013e31815c042f. View

Schwartz S, Faerber G . Dislocation of the testis as a delayed presentation of scrotal trauma. Urology. 1994; 43(5):743-5. DOI: 10.1016/0090-4295(94)90203-8. View

Dogra V, Gottlieb R, Oka M, Rubens D . Sonography of the scrotum. Radiology. 2003; 227(1):18-36. DOI: 10.1148/radiol.2271001744. View

Lin W, Kim E, Quesada E, Lipshultz L, Coburn M . Unilateral testicular injury from external trauma: evaluation of semen quality and endocrine parameters. J Urol. 1998; 159(3):841-3. DOI: 10.1016/s0022-5347(01)63748-0. View

Buckley J, McAninch J . Use of ultrasonography for the diagnosis of testicular injuries in blunt scrotal trauma. J Urol. 2006; 175(1):175-8. DOI: 10.1016/S0022-5347(05)00048-0. View

Hedayati V, Sellars M, Sharma D, Sidhu P . Contrast-enhanced ultrasound in testicular trauma: role in directing exploration, debridement and organ salvage. Br J Radiol. 2012; 85(1011):e65-8. PMC: 3473993. DOI: 10.1259/bjr/95600238. View

Frauscher F, Klauser A, Stenzl A, Helweg G, Amort B, zur Nedden D . US findings in the scrotum of extreme mountain bikers. Radiology. 2001; 219(2):427-31. DOI: 10.1148/radiology.219.2.r01ma42427. View

10.

Lobianco R, Regine R, De Siero M, Catalano O, Caiazzo C, Ragozzino A . Contrast-enhanced sonography in blunt scrotal trauma(). J Ultrasound. 2013; 14(4):188-95. PMC: 3558072. DOI: 10.1016/j.jus.2011.09.003. View

11.

Chandra R, Dowling R, Ulubasoglu M, Haxhimolla H, Costello A . Rational approach to diagnosis and management of blunt scrotal trauma. Urology. 2007; 70(2):230-4. DOI: 10.1016/j.urology.2007.03.064. View

12.

Lin E, Bhatt S, Rubens D, Dogra V . Testicular torsion: twists and turns. Semin Ultrasound CT MR. 2007; 28(4):317-28. DOI: 10.1053/j.sult.2007.05.008. View

13.

Cross J, Berman L, Elliott P, Irving S . Scrotal trauma: a cause of testicular atrophy. Clin Radiol. 1999; 54(5):317-20. DOI: 10.1016/s0009-9260(99)90562-7. View

14.

CASS A, Luxenberg M . Testicular injuries. Urology. 1991; 37(6):528-30. DOI: 10.1016/0090-4295(91)80317-z. View

15.

Donohue R, UTLEY W . Torsion of spermatic cord. Urology. 1978; 11(1):33-6. DOI: 10.1016/0090-4295(78)90195-4. View

16.

Leibovitch I, Mor Y . The vicious cycling: bicycling related urogenital disorders. Eur Urol. 2005; 47(3):277-86. DOI: 10.1016/j.eururo.2004.10.024. View

17.

Kim S, Park S, Choi S, Jeong W, Choi J . Significant predictors for determination of testicular rupture on sonography: a prospective study. J Ultrasound Med. 2007; 26(12):1649-55. DOI: 10.7863/jum.2007.26.12.1649. View

18.

Bhatt S, Dogra V . Role of US in testicular and scrotal trauma. Radiographics. 2008; 28(6):1617-29. DOI: 10.1148/rg.286085507. View

19.

Corrales J, Corbel L, Cipolla B, Staerman F, Darnault P, Guille F . Accuracy of ultrasound diagnosis after blunt testicular trauma. J Urol. 1993; 150(6):1834-6. DOI: 10.1016/s0022-5347(17)35909-8. View

20.

Moore J, Hasenboehler E . Orchiectomy as a result of ischemic orchitis after laparoscopic inguinal hernia repair: case report of a rare complication. Patient Saf Surg. 2008; 1(1):3. PMC: 2241773. DOI: 10.1186/1754-9493-1-3. View