Learning objectives
To describe the crucial role of imaging in the assessment of scrotal trauma depicting the most common imaging findings obteined from various imaging modalities currently in use according to a single centre experience and literature analysis.
Background
Genitourinary tract injuries are rare (3 to 10% of trauma patients) and particularly scrotal injuries account for less than 1% of patients with traumatic associated lesions; this extremely low incidence is due to the testicular mobility,
elasticity and anatomic location which make testis usually relatively protected from injuries.
Scrotal trauma tends to affect relatively young males as result from a wide variety of traumatic mechanisms with a common endpoint of blunt and/or penetrating trauma.
Since that physical examination may be difficult due to testicular pain...
Findings and procedure details
Classification of scrotal trauma based on mechanism of injury
Blunt scrotal trauma
Blunt trauma is the most common mechanism of injury (85%) usually happening with a direct blow to the testis with impingement against the symphysis pubis or ischial ramus.
The most important differential diagnosis is between injuries with rupture of the tunica albuginea,
requiring immediate surgical exploration,
and those in which the albuginea is intact,
usually managed conservatively.
Penetrating scrotal trauma
Penetrating scrotal injuries occur less frequently as result of gunshot and other missile...
Conclusion
Rapid and accurate diagnosis is necessary to guide treatment and prevent potential future serious complications of scrotal trauma,
like testicular atrophy,
infection,
infarction and infertility.
Radiologists should promptly recognize post-traumatic scrotal injuries severity helping in the choice of the best therapeutic approach.
References
Wang A,
Stormont I,
Siddiqui MM.
A Review of Imaging Modalities Used in the Diagnosis and Management of Scrotal Trauma.
Curr Urol Rep.
2017 Oct 28;18(12):98.
Wang Z,
Yang JR,
Huang YM,
Wang L,
Liu LF,
Wei YB et al.
Diagnosis and management of testicular rupture after blunt scrotal trauma: a literature review.
Int Urol Nephrol.
2016 Dec;48(12):1967-1976.
Bertolotto M,
Trombetta C,
Scrotal Pathology,
DOI 10.1007/978-3-642-12456-3,
Springer Heidelberg Dordrecht London New York.
Morey AF,
Brandes S,
Dugi DD III.,
American Urological Association.
Urotrauma AUA guideline....