Treatment of Testicular Trauma: II—Complex Interventions

Abstract

Many cases of testicular amputations occur as a consequence of self-mutilation, and this aspect will be developed in a special section at the end of this book. Many others are reported following an assault, road traffic accident (RTA), or industrial accident. A shattered or badly crushed testis is generally nonviable and should be discarded. However, when a sharp instrument (e.g., knife, scissors, razor, etc.) has penetrated the upper scrotum and severed the spermatic cord, the testis can still be viable if the patient presents within 4–6 h. It should be mentioned that unilateral injury exceptionally justifies a fastidious microsurgical replantation taking into account the very small diameters of involved vessels, the necessity for specialized centers, and the uncertainty of success. But when dealing with a solitary testis or bilateral testes amputation in a young patient victim of accident or assault, all local and regional competencies should be solicited to optimize the future chances of the unfortunate patient to live a normal marital life and prevent psychological drama.