Aim Scrotal bruises are quite frequent injuries affecting young subjects, with psychological repercussions on body image and fertility. The interest of ultrasound in the context of the emergency remains controversial. The aim of our study was to investigate clinical, ultrasonographic and operative features of scrotal contusions, and to evaluate the contribution of ultrasound in the description of traumatic lesions. Methods In this retrospective and descriptive study 71 scrotal contusions operated from December 2015 to April 2020 were collected. We retrospectively analysed 26 patients (aged between 14 and 79 years) of 71 who sustained a scrotal ultrasound, where the latter was positive. The primary endpoint was albuginea rupture, whose concordance between ultrasound and surgery was assessed using the Kappa method. Positive and negative predictive values, sensitivity and specificity for the presence of albuginea rupture were evaluated for a set of ultrasound data: scrotal haematoma, haematocele, regularity of testicular contours, testicular fracture (specificity (93%), testicular haematoma, and Doppler signal intensity. Results Surgical treatment was necessary in 26 (37%) patients; only six orchiectomy were performed. Surgical exploration should be performed if haematocele is found in the genital examination without any ultrasound complement. Conclusion The ultrasonography is useful, detailed and accurate when the haematocele is not clinically evident.
Frauscher F, Klauser A, Stenzl A, Helweg G. Amort B, zur Nedden D. US findings in the scrotum of extreme mountain bikers. Radiology. 2001;427–31.
2.
Churukanti G, Kim A, Rich D, Schuyler K, Lavien G, Stein D, et al. Role of ultrasonography for testicular injuries in penetrating scrotal trauma. Urology. 2016;208–12.
3.
Powers R, Hurley S, Park E, Mcardle B, Vidal P, Psutka S, et al. Usefulness of preoperative ultrasound for the evaluation of testicular rupture in the setting of scrotal gunshot wounds. J Urol. 2018;1546–51.
4.
Manno S, Cicione A, Dell’atti L, Td G. Amazing result of Nivolumab in a patient with multiple carcinomas. J BUON. 2019;865–7.
5.
Muglia V, Tucci S, Jr E, Jr, Trad C, Bilbey J, et al. Magnetic resonance imaging of scrotal diseases: when it makes the difference. 2002;419–23.
6.
Lee S, Bak C, Choi M, Lee H, Lee M, Yoon S. Trauma to male genital organs: a 10-year review of 156 patients, including 118 treated by surgery. BJU Int. 2008;211–5.
7.
Andipa E, Liberopoulos K, Asvestis C. Magnetic resonance imaging and ultrasound evaluation of penile and testicular masses. World J Urol. 2004;382–91.
8.
Wang Z, Yang J, Huang Y, Wang L, Liu L, Wei Y, et al. Diagnosis and management of testicular rupture after blunt scrotal trauma: a literature review. Int Urol Nephrol. 2016;1967–76.
9.
Cass A, Luxenberg M. Testicular injuries. Urology. 1991;528–30.
10.
Nagarajan V, Pranikoff K, Imahori S, Rabinowitz R. Traumatic dislocation of testis. Urology. 1983;521–4.
11.
Koraitim AAI, M. Lower genitourinary trauma in modern warfare: the experience from civil violence in Iraq. Injury. 2014;885–9.
12.
Lawson J, Rotem T, Wilson S. Catastrophic injuries to the eyes and testicles in footballers. Med J Aust. 1995;242–4.
13.
Jeffrey R, Laing F, Hricak H, Mcaninch J. Sonography of testicular trauma. AJR Am J Roentgenol. 1983;993–5.
14.
Monga M, Hellstrom W. Testicular Trauma. Adolesc Med. 1996;(1):141–8.
15.
Brandes S, Buckman R, Chelsky M, Hanno P. External genitalia gunshot wounds: a ten-year experience with fifty-six cases. J Trauma. 1995;266–71.
16.
Bryk D, Zhao L. Guideline of guidelines: a review of urological trauma guidelines. BJU Int. 2016;226–34.
17.
Ronchi P, Manno S, Dell’atti L. Technology meets tradition: CO 2 laser circumcision versus conventional surgical technique. Res Rep Urol. 2020;255–60.
18.
Isidori A, Pozza C, Gianfrilli D, Giannetta E, Lemma A, Pofi R, et al. Differential diagnosis of nonpalpable testicular lesions: qualitative and quantitative contrast-enhanced US of benign and malignant testicular tumors. Radiology. 2014;606–18.
19.
Bhatt S, Dogra V. Role of US in testicular and scrotal trauma. Radiographics. 2008;1617–29.
20.
Guichard G, Ammari E, J, Coro D, Cellarier C, Loock D, et al. Accuracy of ultrasonography in diagnosis of testicular rupture after blunt scrotal trauma. Urology. 2008;52–6.
21.
Buckley J, Mcaninch J. Use of ultrasonography for the diagnosis of testicular injuries in blunt scrotal trauma. J Urol. 2006;175–8.
22.
Learch T, Hansch L, Ralls P. Sonography in patients with gunshot wounds of the scrotum: imaging findings and their value. AJR Am J Roentgenol. 1995;(4):879–83.
23.
Randhawa H, Blankstein U, Davies T. Scrotal trauma: A case report and review of the literature. Can Urol Assoc J. 2019;(6):67–71.
24.
Nicola R, Carson N, Dogra V. Imaging of traumatic injuries to the scrotum and penis. AJR Am J Roentgenol. 2014;512–20.
The statements, opinions and data contained in the journal are solely those of the individual authors and contributors and not of the publisher and the editor(s). We stay neutral with regard to jurisdictional claims in published maps and institutional affiliations.