Abstract
Introduction
Traumatic testicular dislocation is a rare entity. It occurs after a direct blunt scrotal trauma causing the testicle to migrate outside the scrotum, most frequently to the superficial inguinal region.
Materials and methods
A review of the diagnostic database of our two institutions was performed searching for complex genital trauma between 1990 and 2012.
Results
Seven cases of traumatic testicular dislocation were identified (four on the left side; one on the right side and two bilateral) for a total of nine testicles. Six were motorcycle accidents, and the other case suffered a pelvic crush injury. All victims had significant associated injuries, one case had an open dislocation and two were killed by the accident. The testicle was located at the inguinal region in four cases at the suprapubic area in four, and the other was an open dislocation. Diagnosis was suspected with the physical examination and confirmed by Doppler ultrasound; however, in one case, the diagnosis was missed during several weeks. In one case, the testicle was reduced into the scrotum immediately at the emergency department. Two cases were operated shortly after admission, performing testicular reduction into the scrotum and standard orchidopexy. Two other cases underwent delayed intervention, and both needed release of peri-testicular adhesions. Two cases (both bilateral) died at the accident site and were diagnosed by autopsy. In all surviving cases, it was possible to obtain a satisfactory orchidopexy with gonadal preservation.
Conclusions
Traumatic testicular dislocation is rare and diagnosis can be elusive. It should be suspected in motorcycle and high-energy accidents around the groin area and depends on a careful physical examination. With proper management, prognosis is excellent.
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References
Claubry EG (1818) Observacions sur une retrocession subite des deux testicles dans l′ abdomen, a la suite d’une violente compression de la parte inférieure de la paroid abdominale par une roué de la charrette. J Gén Méd Chir Prham 64:325–328
López Alcina E, Martín JC, Fuster A, Pérez J, Puertas M, Moreno J (2001) Dislocación testicular, aportación de 2 nuevos casos y revisión de la literatura. Acta Urol Esp 25:299–302
Ihama Y, Fuke C, Miyazaki T (2007) A two-rider motorcycle accident involving injuries around groin area in both the driver and the passenger. Leg Med (Tokyo) 9:274–277
Phuwapraisirisan S, Lim M, Suwanthanma W (2010) Surgical reduction in a delayed case of traumatic testicular dislocation. J Med Assoc Thail 93:1317–1320
Sakamoto H, Iwasaki S, Hushima M, Shichijo T, Ogawa Y (2008) Traumatic bilateral testicular dislocation: a recovery of spermatogenesis by orchiopexy 15 years after the onset. Fertil Steril 90:9–11
Choi SE, Kiik MC, Kim CJ, Lee SC, Park KW, Jung SE, Kim WK (2009) Effects of compression/stretching of the spermatic cord and blunt dissection on testicular growth and fertility. J. Pediatri Surg 44:2163–2167
Yoshimura K, Okubo K, Ihioka K, Terada N, Matsuta Y, Arai Y (2002) Restoration of spermatogenesis by orchiopexy 13 years after bilateral traumatic testicular dislocation. J Urol 167:649–650
Lee JY, Cass AS, Streitz KM (1992) Traumatic dislocation of testes and bladder rupture. Urology 40:506
Ko SF, Ng SH, Wan YL, Huang CC, Lee TY, Kung CT, Liu PP (2004) Testicular dislocation: an uncommon and easily overlooked complication of blunt abdominal trauma. Ann Emerg Med 43:371–375
Kochakarn W, Choonhaklai V, Hotrapawanond P, Muangman V (2000) Traumatic testicular dislocation a review of 36 cases. J Med Assoc Thail 30:409–411
Nagarajan VP, Pranikoff K, Imahori SC et al (1983) Traumatic dislocation of testis. Urology 22:521
Ezra N, Afari A, Wong J (2009) Pelvic and scrotal trauma: CT and triage of patients. Abdom Imaging 34:541–544
Tsurukiri J, Nauyuki K, Shiro M (2011) Bilateral traumatic testicular dislocation. Urology 76:1306
Morgan A (1965) Traumatic luxation of the testis. Br J Surg 52:669
Luján S, Budía A, Bango V, Ramírez M, Delgado FJ, Jiménez JF (2006) Dislocación testicular postraumática. Acta Urol Esp 30:409–411
Schwartz SL, Faerber GJ (1994) Dislocation of the testis as a delayed presentation of scrotal trauma. Urology 43:743
Jecmenica D, Alempijevic D, Pavlekic S, Aleksandrik B (2011) Traumatic testicular displacement in motorcycle driver. J of Forensic Sci 56:541–543
Vasudeva H, Dalela D, Singh D, Goel A (2010) Traumatic testicular dislocation: a reminder for the unwary. J Emerg Trauma Shock 3:418–419
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Gómez, R.G., Storme, O., Catalán, G. et al. Traumatic testicular dislocation. Int Urol Nephrol 46, 1883–1887 (2014). https://doi.org/10.1007/s11255-014-0736-8
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DOI: https://doi.org/10.1007/s11255-014-0736-8