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Pérez-Bertólez S, Godoy-Lenz J, Alonso V. Traumatic rupture of testicle and epididymis. An Pediatr (Barc) 2024; 100:305-306. [PMID: 38580591 DOI: 10.1016/j.anpede.2024.03.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Accepted: 02/02/2024] [Indexed: 04/07/2024] Open
Affiliation(s)
- Sonia Pérez-Bertólez
- Servicio de Cirugía Pediátrica, Centro Médico Teknon, grupo Quirónsalud, Barcelona, Spain; Servicio de Cirugía Pediátrica, Hospital Universitari Dexeus, grupo Quirónsalud, Barcelona, Spain; Unidad de Urología Pediátrica, Servicio de Cirugía Pediátrica, Hospital Sant Joan de Déu, Universidad de Barcelona, Barcelona, Spain.
| | - Jorge Godoy-Lenz
- Servicio de Cirugía Pediátrica, Hospital Luis Calvo Mackenna, Santiago, Chile; Servicio de Cirugía Pediátrica, Clínica Alemana de Santiago, Santiago, Chile
| | - Verónica Alonso
- Servicio de Cirugía Pediátrica, Hospital Universitario de Burgos, Burgos, Spain
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2
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Horiguchi A, Shinchi M, Ojima K, Iijima K, Inoue K, Inoue T, Kaneko N, Kanematsu A, Saito D, Sakae T, Sugihara T, Sekine K, Takao T, Tabei T, Tamura Y, Funabiki T, Yagihashi Y, Yanagi M, Takahashi S, Nakajima Y. The Japanese Urological Association's clinical practice guidelines for urotrauma 2023. Int J Urol 2024; 31:98-110. [PMID: 37929795 DOI: 10.1111/iju.15331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 10/10/2023] [Indexed: 11/07/2023]
Abstract
The Japanese Urological Association's guidelines for the treatment of renal trauma were published in 2016. In conjunction with its revision, herein, we present the new guidelines for overall urotrauma. Its purpose is to provide standard diagnostic and treatment recommendations for urotrauma, including iatrogenic trauma, to preserve organ function and minimize complications and fatality. The guidelines committee comprised urologists with experience in urotrauma care, selected by the Trauma and Emergency Medicine Subcommittee of the Specialty Area Committee of the Japanese Urological Association, and specialists recommended by the Japanese Association for the Surgery of Trauma and the Japanese Society of Interventional Radiology. The guidelines committee established the domains of renal and ureteral, bladder, urethral, and genital trauma, and determined the lead person for each domain. A total of 30 clinical questions (CQs) were established for all domains; 15 for renal and ureteral trauma and five each for the other domains. An extensive literature search was conducted for studies published between January 1, 1983 and July 16, 2020, based on the preset keywords for each CQ. Since only few randomized controlled trials or meta-analyses were found on urotrauma clinical practice, conducting a systematic review and summarizing the evidence proved challenging; hence, the grade of recommendation was determined according to the 2007 "Minds Handbook for Clinical Practice Guidelines" based on a consensus reached by the guidelines committee. We hope that these guidelines will be useful for clinicians in their daily practice, especially those involved in urotrauma care.
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Affiliation(s)
- Akio Horiguchi
- Department of Urology, National Defense Medical College, Tokorozawa, Saitama, Japan
- Division of Trauma Reconstruction, National Defense Medical College, Tokorozawa, Saitama, Japan
| | - Masayuki Shinchi
- Department of Urology, National Defense Medical College, Tokorozawa, Saitama, Japan
| | - Kenichiro Ojima
- Department of Urology, National Defense Medical College, Tokorozawa, Saitama, Japan
| | - Kazuyoshi Iijima
- Department of Urology, Nagano Municipal Hospital, Nagano, Nagano, Japan
| | - Koji Inoue
- Department of Urology, Kurashiki Central Hospital, Kurashiki, Okayama, Japan
| | - Takamitsu Inoue
- Department of Nephrology and Urological Surgery, International University of Health and Welfare, Otawara, Tochigi, Japan
| | - Naoyuki Kaneko
- Trauma and Emergency Center, Fukaya Red Cross Hospital, Fukaya, Saitama, Japan
| | - Akihiro Kanematsu
- Department of Urology, Hyogo Medical University, Nishinomiya, Hyogo, Japan
| | - Daizo Saito
- Graduate School of Emergency Medical System, Kokushikan University, Setagaya, Tokyo, Japan
| | - Tatefumi Sakae
- IVR Center, Miyazaki University Hospital, Miyazaki, Japan
| | - Toru Sugihara
- Department of Urology, Jichi Medical University, Shimotsuke, Tochigi, Japan
| | - Kazuhiko Sekine
- Department of Emergency and Critical Care Medicine, Tokyo Saiseikai Central Hospital, Minato, Tokyo, Japan
| | - Tetsuya Takao
- Department of Urology, Osaka General Medical Center, Osaka, Japan
| | - Tadashi Tabei
- Department of Urology, Fujisawa Shonandai Hospital, Fujisawa, Kanagawa, Japan
| | - Yoshimi Tamura
- Department of Urology, Shibukawa Medical Center, Shibukawa, Gunma, Japan
| | - Tomohiro Funabiki
- Advanced Emergency and Critical Care Center, Fujita Health University Hospital, Toyoake, Aichi, Japan
| | - Yusuke Yagihashi
- Department of Urology, Shizuoka City Shizuoka Hospital, Shizuoka, Japan
| | - Masato Yanagi
- Department of Urology, Nippon Medical School Hospital, Tokyo, Japan
| | - Satoru Takahashi
- Department of Urology, Nihon University School of Medicine, Tokyo, Japan
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Atwine O, Mucunguzi D, Ainomugisha R, Muhumuza J, Mwesigwa MM. Traumatic bilateral testicular amputation in a 31 year old male: A case report. Int J Surg Case Rep 2023; 111:108893. [PMID: 37797527 PMCID: PMC10551646 DOI: 10.1016/j.ijscr.2023.108893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 09/26/2023] [Accepted: 09/28/2023] [Indexed: 10/07/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE Testicular loss following assault is a very rare occurrence and uncommon in the low income countries. Testicular amputation is usually associated with blast injuries, sexual violence and self-mutilation in psychiatric cases. Management involves a multidisciplinary approach and is focused on resuscitation, aggressive debridement, testosterone supplementation, and reconstructive surgery. CASE PRESENTATION We present a 31 year old male referred to the emergency department of a Regional Referral Hospital in western Uganda with a history of trauma to his scrotum. The patient had been well till 16 h prior to presentation when he was attacked by unknown assailants who broke into his house in the night. The patient was reportedly beaten before his scrotum was pulled and amputated with eventual profuse bleeding. Evacuation of approximately 150 cc hematoma was done plus debridement of necrotic testes and achieving hemostasis. DISCUSSION AND CONCLUSION To the best of our knowledge, this was the first reported case of bilateral traumatic testicular amputation as a result of assault. Revascularization with micro-vascular techniques can be done if the patient presents early, but due to late presentation, the patient was only managed with aggressive debridement, reconstruction and testosterone supplementation.
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Affiliation(s)
- Oscar Atwine
- Department of Surgery, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Denis Mucunguzi
- Department of Surgery, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Racheal Ainomugisha
- Department of Radiology, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Joshua Muhumuza
- Department of Surgery, Faculty of clinical medicine and dentistry, Kampala International University Western campus, Ishaka-Bushenyi, Uganda; Department of Surgery, Mubende Regional Referral Hospital, Mubende, Uganda.
| | - Marvin Mutakooha Mwesigwa
- Department of Surgery, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
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Shams M, Tanveer Y, Iqbal M. Complete Rupture of Testis After Blunt Trauma. Cureus 2023; 15:e47968. [PMID: 38034133 PMCID: PMC10685986 DOI: 10.7759/cureus.47968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/29/2023] [Indexed: 12/02/2023] Open
Abstract
Testicular trauma can be classified aetiologically as blunt or penetrative. Bicycles and motorbikes are considered high risk for road traffic accidents accounting for 9-17% % of all blunt trauma. We present a case of assessment and management of isolated blunt testicular trauma in a tertiary care hospital. A 36-year-old gentleman presented to the accident and emergency department with testicular pain after a road traffic accident while riding a motorcycle. On arrival, he was fully conscious and denied any other injuries. On examination, he had bruising and gross swelling of the right hemiscrotum. Ultrasound of the scrotum revealed testicular rupture and emergency exploration was undertaken which confirmed the diagnosis. Testis was non-salvageable therefore orchidectomy was done. The patient had unremarkable post-operative recovery. A majority of testicular ruptures are secondary to blunt trauma mainly caused by sport-related injuries and road traffic accidents. Ultrasonography remains a non-invasive modality to investigate testicular injuries with a sensitivity of 100%. When not available in an emergency setting, scrotal exploration should be undertaken for both diagnostic and therapeutic purposes. Surgical repair done within 72 hours yields a 90% salvage rate after which the salvage rate is reduced significantly. Tumor markers should be checked in patients managed conservatively. Early assessment and diagnosis are crucial in the management of acute testicular rupture. Early intervention can salvage injured testes and an orchidectomy can be avoided.
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Affiliation(s)
| | | | - Maryam Iqbal
- Internal Medicine, Sheikh Zayed Medical College and Hospital, Rahim Yar Khan, PAK
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Ravichandran S, Smith PM, Tang V. Genital self-amputation—its psychological urge. J Surg Case Rep 2022; 2022:rjac569. [PMCID: PMC9741515 DOI: 10.1093/jscr/rjac569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Accepted: 11/19/2022] [Indexed: 12/14/2022] Open
Abstract
Abstract
Genital self-mutilation (GSM) is a rare phenomenon that can occur in patients with severe mental health illness. This case report highlights a rare case of self-inflicted bilateral testicular amputation and partial penile amputation in a patient who is a transwoman with a psychiatric history. The patient initially presented to urology in extremis with bilateral testicular amputation. The patient was resuscitated but required emergency surgery in the form of bilateral inguinal approach to ligate the cord and control haemostasis. The testes were not re-implanted as the patient refused and, after psychiatric discussion, was deemed to have capacity. She then re-presented within a week with self-inflicted partial amputation of penis. On both admissions, the patient had psychiatric evaluation but she was sectioned under the mental health act the second time. This case demonstrates how one can control haemostasis in the emergency scenarios of GSM and emphasizes the importance of psychiatric illness and evaluation in patients presenting with GSM.
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Affiliation(s)
| | - Peter Mark Smith
- Stepping Hill Hospital Department of Urology, , Stockport SK2 7JE , UK
| | - Vincent Tang
- Stepping Hill Hospital Department of Urology, , Stockport SK2 7JE , UK
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Wu M, Chen R, Xu Y, Shi X, Song R, Sun M, Xue C, Wang Y, Zhang W. At The Forefront of Penile Surgical Reconstruction: A Bibliometric Study of the 100 Most-Cited Articles. Aesthetic Plast Surg 2022; 46:480-488. [PMID: 34595594 DOI: 10.1007/s00266-021-02609-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 09/19/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE The citation count of a scientific article is considered as the recognition it received from this field. The purpose of this bibliometric analysis was to identify the top 100 most-cited scientific articles in penile surgical reconstruction. METHODS The Web of Science database was used to extract the top 100 most-cited articles. Individual articles were reviewed to identify the authorship, published journal, journal impact factor (IF), primary disease, article type, institution and country of origin, and year of publication. RESULTS The top 100 most-cited articles were published between 1947 and 2013. The number of citations ranged from 23 to 233. Journal of Urology contributed the most articles (n = 36). Articles with a high level of evidence like prospective analysis (n = 5), systematic review and meta-analysis (n = 2), and guideline (n = 1) were all published after 2000. The average citation per year of articles published in high-IF journals was significantly higher than that of other articles (p = 0.0129). There was a positive linear correlation between citation count per year and publication year (r2 = 0.26, p < 0.001). Among the top 100 articles, 74 articles were interlinked via citation of each other. The major topic of co-citation network was the application of flaps in penile reconstruction. CONCLUSIONS The analysis of top 100 most-cited articles facilitates the comprehensive recognition of current focus in the field of penile surgical reconstruction, which is the exploration of flaps and development of new techniques in penile reconstruction. In the future, more attention should be paid to evidence-based medicine to provide high-level evidence for research. LEVEL OF EVIDENCE III This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Affiliation(s)
- Minliang Wu
- Department of Plastic Surgery, Changhai Hospital, Naval Medical University, 168 Changhai Rd, Shanghai, 200433, China
| | - Rui Chen
- Department of Urology, Changhai Hospital, Naval Medical University, 168 Changhai Rd, Shanghai, 200433, China
| | - Yalong Xu
- Department of Urology, Changhai Hospital, Naval Medical University, 168 Changhai Rd, Shanghai, 200433, China
- Department of Urology, General Hospital of Central Theater Command, Wuhan, 430070, Hubei, China
| | - Xiaolei Shi
- Department of Urology, Changhai Hospital, Naval Medical University, 168 Changhai Rd, Shanghai, 200433, China
| | - Ruixiang Song
- Department of Urology, Changhai Hospital, Naval Medical University, 168 Changhai Rd, Shanghai, 200433, China
| | - Mengyan Sun
- Department of Plastic Surgery, Changhai Hospital, Naval Medical University, 168 Changhai Rd, Shanghai, 200433, China
| | - Chunyu Xue
- Department of Plastic Surgery, Changhai Hospital, Naval Medical University, 168 Changhai Rd, Shanghai, 200433, China
| | - Yuchong Wang
- Department of Plastic Surgery, Changhai Hospital, Naval Medical University, 168 Changhai Rd, Shanghai, 200433, China.
| | - Wei Zhang
- Department of Urology, Changhai Hospital, Naval Medical University, 168 Changhai Rd, Shanghai, 200433, China.
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7
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Clement KD, Light A, Asif A, Wai-Shun Chan V, Shah TT, Kasivisvanathan V. Finding consensus for orchIdopeXy In Torsion (FIX-IT). BJU Int 2021; 126:642-643. [PMID: 33462990 DOI: 10.1111/bju.15271] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Keiran D Clement
- University Hospital Monklands, Airdrie, UK.,British Urology Researchers in Surgical Training (BURST), UK
| | - Alexander Light
- British Urology Researchers in Surgical Training (BURST), UK.,Department of Surgery, University of Cambridge, Cambridge, UK
| | - Aqua Asif
- British Urology Researchers in Surgical Training (BURST), UK.,Leicester Medical School, University of Leicester, Leicester, UK
| | - Vinson Wai-Shun Chan
- British Urology Researchers in Surgical Training (BURST), UK.,Leeds Medical School, University of Leeds, Leeds, UK
| | - Taimur T Shah
- British Urology Researchers in Surgical Training (BURST), UK.,Division of Surgery, Department of Surgery and Cancer, Imperial College London, London, UK.,Department of Urology, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK
| | - Veeru Kasivisvanathan
- British Urology Researchers in Surgical Training (BURST), UK.,UCL Division of Surgery & Interventional Science, Urology, University College London, London, UK.,Department of Urology, University College London Hospitals NHS Foundation Trust, London, UK
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Koller CR, Wang S, Sandoval V, Yousif A, Hsieh TC, Raheem OA. Self-Induced Trauma to the Genitalia: a Review of the Literature and Management Schemes. Curr Urol Rep 2021; 22:18. [PMID: 33534050 DOI: 10.1007/s11934-021-01034-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/04/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW Self-induced genital trauma is rare, and prompt and evidence-based early intervention can improve the urinary and sexual function of these complex patients. This review has surveyed current literature and treatment trends to evaluate the clinical approach to managing genital trauma. RECENT FINDINGS A literature review was performed regarding self-induced genitalia trauma and trauma management between 2000 and 2019 using MEDLINE® database, the Cochrane Library® Central Search, Web of Science, and Google Scholar. In total, 42 articles were considered relevant and included in this review. Self-induced trauma can be appropriately managed with a multidisciplinary approach. Treatment goals are to preserve urinary, sexual, and reproductive function. Specific evaluation includes mechanism of injury, imaging, and determining the extent of injury and surgical repair, if indicated. Due to the rarity of these injuries and their emergent nature, much of the management is based on retrospective data. Further research is needed to improve long-term functional outcomes in trauma patients.
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Affiliation(s)
- Christopher R Koller
- Department of Urology, Tulane University School of Medicine, 1430 Tulane Ave. 8642 Room 3514, New Orleans, LA, 70112, USA
| | - Shuhong Wang
- Department of Andrology, Chongqing University Three Gorges Hospital, Chongqing, China
| | - Victor Sandoval
- Department of Urology, Hospital Valentin Gomez Farias, Guadalajara, Mexico
| | - Ayad Yousif
- Department of Urology, Tulane University School of Medicine, 1430 Tulane Ave. 8642 Room 3514, New Orleans, LA, 70112, USA
| | - Tung-Chin Hsieh
- Department of Urology, University of California San Diego Health, San Diego, California, USA
| | - Omer A Raheem
- Department of Urology, Tulane University School of Medicine, 1430 Tulane Ave. 8642 Room 3514, New Orleans, LA, 70112, USA.
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Imaging in scrotal trauma: a European Society of Urogenital Radiology Scrotal and Penile Imaging Working Group (ESUR-SPIWG) position statement. Eur Radiol 2021; 31:4918-4928. [DOI: 10.1007/s00330-020-07631-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 11/16/2020] [Accepted: 12/11/2020] [Indexed: 02/08/2023]
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10
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Franco-Buenaventura D, Vallecilla K, Garavito Gualdrón YNG, Osorio JD, García-Perdomo HA. Traumatic avulsion of the spermatic cord due to blunt inguinal trauma: A case report. TRAUMA-ENGLAND 2020. [DOI: 10.1177/1460408620968339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
We report an extremely rare case of a patient with a total avulsion of the spermatic cord secondary to a blunt inguinal trauma. Doppler ultrasound was used to identify an absence of vascular flow and an indication for exploratory surgery. The retroperitoneum was accessed for hemostasis. Spermatic cord injury after blunt trauma is extremely rare but should be considered as a cause of an avascular testis after trauma.
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Affiliation(s)
- Daniela Franco-Buenaventura
- Department of Surgery/Urology, School of Medicine, Universidad del Valle, Cali, Colombia
- UROGIV Research Group, School of Medicine, Universidad del Valle, Cali, Colombia
| | - Katherine Vallecilla
- UROGIV Research Group, School of Medicine, Universidad del Valle, Cali, Colombia
| | | | - José Daniel Osorio
- Department of Surgery/Urology, School of Medicine, Universidad del Valle, Cali, Colombia
- UROGIV Research Group, School of Medicine, Universidad del Valle, Cali, Colombia
| | - Herney Andrés García-Perdomo
- Department of Surgery/Urology, School of Medicine, Universidad del Valle, Cali, Colombia
- UROGIV Research Group, School of Medicine, Universidad del Valle, Cali, Colombia
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Leung LY, Seth J, Gonsalves M, Watkin N, Sharma D. Testicular rupture: Simplifying the diagnosis. JOURNAL OF CLINICAL UROLOGY 2020. [DOI: 10.1177/2051415819887314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objective: To review the use of ultrasound imaging in the diagnosis of testicular rupture and in relation to current guidelines. Methods: Data was retrospectively collected for all patients diagnosed with testicular rupture at a major trauma centre between 2011 and 2018. Data included patient demographics, mechanism of trauma, specific findings on ultrasound and outcomes. On review of ultrasound imaging, specific findings identified include a breach in the tunica albuginea (currently advised in guidelines), heterogenicity and contour loss. Results: Eight patients were identified with average age 37 years old, mechanism of trauma was 50%, 37.5% and 12.5% for motorcycle road traffic collision, sporting injury and workplace injury respectively. A breach of tunica albuginea was identified on ultrasound in 65% of cases, compared with 100% of cases showing contour loss and heterogenicity. Of the 87.5% patients who were managed surgically one needed orchidectomy (and later testosterone replacement). Conclusion: Guidelines have varied on how to use ultrasound imaging in diagnosing a clinically difficult condition. Our case series demonstrates that diagnosing testicular rupture by looking for more easily identifiable characteristics (heterogenicity and contour loss) than currently recommended in the guidelines (breech in the tunica albuginea) will aid diagnosis and patient pathway and improve outcomes. Level of evidence: 5
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Affiliation(s)
- Lap Yan Leung
- Department of Urology, St George’s University Hospital NHS Foundation Trust, London, UK
| | - Jai Seth
- Department of Urology, St George’s University Hospital NHS Foundation Trust, London, UK
| | - Michael Gonsalves
- Department of Radiology, St George’s University Hospital NHS Foundation Trust, London, UK
| | - Nick Watkin
- Department of Urology, St George’s University Hospital NHS Foundation Trust, London, UK
| | - Davendra Sharma
- Department of Urology, St George’s University Hospital NHS Foundation Trust, London, UK
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12
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Dasgupta P. The British Association of Urological Surgeons (BAUS) consensus documents on andrology. BJU Int 2018; 121:820. [DOI: 10.1111/bju.14381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Prokar Dasgupta
- MRC Centre for Transplantation; King's College London; London UK
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