Humans ; Male ; Scrotum/injuries* ; Testis/injuries*

PURPOSETo enhance the awareness of rare complications of pelvic fracture and describe the correct diagnosis and effective treatment.

METHODSA total of 188 cases of pelvic fractures were retrospectively reviewed, and four patients who suffered from four types of rare pelvic fracture complications were described, namely ureteral obstruction caused by retroperitoneal hematoma-induced abdominal compartment syndrome (ACS), bowel entrapment, external iliac artery injury, and open scrotal sac injury.

RESULTSWe demonstrated that combined measures should be employed to prevent the occurrence of ACS following major pelvic fractures. Ureteral catheter support may be a good option at an early stage when ACS occurred. Contrasted computed tomography examination and sufficient awareness are keys to a correct diagnosis of bowel entrapment following pelvic fractures. Recognition of risk factors, early diagnosis, and prompt treatment of suspected injury of the external iliac artery are keys to patient survival and to avoid limb loss. Scrotal and/or testicular injury complicated by pelvic fractures should be carefully treated to maintain normal gonad function. Additionally, establishment of a sophisticated trauma care system and multi-disciplinary coordination are important for correct diagnosis and treat- ment of rare complications in pelvic fractures.

CONCLUSIONSRare complications of pelvic fractures are difficult to diagnose and negatively impact outcome. Recognition of risk factors and sufficient awareness are essential for correct diagnosis and prompt treatment.

Adult ; Female ; Fractures, Bone ; complications ; Humans ; Iliac Artery ; injuries ; Intra-Abdominal Hypertension ; diagnosis ; therapy ; Male ; Middle Aged ; Pelvic Bones ; injuries ; Scrotum ; injuries ; Testis ; injuries ; Tomography, X-Ray Computed

OBJECTIVETo report 31 cases and 32 testicles of testicular injuries and summarize the experience of treatment.

METHODSThirty-one patients suffered from testicular injuries which included 26 cases of closed injuries and 5 cases of open injuries. Nine cases were treated with expectant treatment (surgical treatment were performed in 2 out of 9 cases later) and 22 cases were treated with surgical treatment directly.

RESULTSTwenty-five patients and 26 testicles were followed up from 7 months to 9 years,which included 9 cases of expectant treatment and 16 cases of surgical treatment. There were 2 patients with orchiatrophy in expectant treatment group and surgical treatment group respectively. No patient had testicular sclerosis and chronic pain.

CONCLUSIONPatients suffering from scrotal trauma or perineal trauma, might have testicular injuries simultaneously. The ultrasonic examination is preferred in these patients. Expectant treatment should be performed under the ultrasonic monitoring and some patients should be underwent operations research actively.

Adolescent ; Adult ; Child ; Child, Preschool ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Testis ; injuries ; Wounds and Injuries ; surgery

Spinal cord injury (SCI) commonly affects males in their reproductive years. After spinal cord injury, most men experience fertility related problems including erectile and ejaculatory dysfunction, impaired spermatogenesis, abnormal sperm viability, motility, and morphology, genitourinary infection and endocrine abnormalities. In this article we will review the pathophysiology, evaluation and management of infertility in spinal cord injury. The impact of spinal cord injury on seminal plasma and the contribution of seminal oxidative stress to the poor sperm quality of men with spinal cord injury will be presented. Success with sperm retrieval techniques and assisted reproductive technology in SCI men with spinal cord injury will be discussed.
Ejaculation ; Humans ; Infertility, Male ; etiology ; Male ; Reproductive Techniques ; Semen ; Spinal Cord Injuries ; complications ; physiopathology ; Testis ; physiopathology

PURPOSE: According to the AAST (American Association for the Surgery of Trauma) injuries to the testes are rare, but there are many reports in the literature on other organs using the AAST Organ Injury Scale (OIS). In the present study, the authors evaluated the usefulness of the AAST OIS when applied to the testis. MATERIALS AND METHODS: A retrospective review was performed on 65 patients (mean age 30.0 years) with a testis injury treated between March 1986 and July 2006. Of the 65 patients, preoperative ultrasonography was performed on 51. Injuries were classified according to the OIS of the AAST, based on history taking, a physical examination and scrotal ultrasonography. RESULTS: Of the 51 patients, 46 and 5 underwent surgical intervention and conservative management, respectively. Of the included patients, 38 were found to have abnormal testis contours on ultrasonography, 29 had a rupture of the tunica albuginea, with a sensitivity of 76.3%. Of the 13 patients with normal contours, the tunica albuginea was normal in 7, and 8 underwent operation, with a specificity of 87.5%. Of the 12 Grade I patients, 7 underwent an operation, but the testes contours were normal. Of the 8 Grade II patients, only 1 underwent a primary repair with partial orchiectomy, but of the 45 Grades III, IV or V patients, 35 underwent a primary repair with a partial orchiectomy or orchiectomy with a hematoma evacuation performed in 10. CONCLUSIONS: Ultrasonography was found to be the most effective modality for detecting a rupture of the tunica albuginea, and the authors conclude that the AAST OIS can be used to determine the treatment modality. Our recommended treatment policy is as follows; conservative for Grade I, exploration and repair for Grade II, and exploration, and a partial orchiectomy or orchiectomy for Grades III, IV or V. In particular, an orchiectomy is the most commonly used modality for Grade V.
Hematoma ; Humans ; Orchiectomy ; Physical Examination ; Retrospective Studies ; Rupture ; Sensitivity and Specificity ; Testis ; Ultrasonography ; Wounds and Injuries

A hypoplastic empty scrotum is a critical factor in the success of implantation of artificial testis. A hypoplastic scrotum increases the postoperative complication, such as wound dehiscence and prosthesis extrusion. Any technique cannot overcome this problem satisfactorily. Furthermore previous operative scars and inflammatory disease as epididymo-orchitis have often added to the difficulties. Enlarging the scrotum by gradual distention of a tissue expander implanted in the contracted scrotum has been successful in overcoming this problem. We report a case of successful artificial testes implantation after gradually enlarging scrotum by tissue expander in a 6 year old boy, who was diagnosed anorchidism with scrotal hypoplasia.
Child ; Cicatrix ; Humans ; Male ; Postoperative Complications ; Prostheses and Implants ; Scrotum ; Testis* ; Tissue Expansion Devices* ; Wounds and Injuries

The objectives of this study were to investigate patients treated for scrotal trauma at our institute for the last three decades to describe our experience with an emphasis on the etiologies and ultrasonographic findings in these patients. We reviewed medical records of patients who underwent scrotal ultrasonography for evaluation of testicular trauma at our institutes from 1986 to 2015. Trends regarding the etiology of scrotal trauma were evaluated during each decade. The echo pattern and contour definition of the testicular parenchyma and the pattern of hematoma development were recorded to evaluate radiographic findings of testicular injury. The correlation between ultrasonographic and intraoperative findings was assessed. A total of 115 patients were analyzed. Most patients (92.2%) presented with blunt trauma. The most common etiology of testicular trauma was assault during the first and second decades, while injury related to a fall was most common during the third decade. Of the 77 patients (67.0%) who underwent urgent exploration, 46 patients (59.7%) had testicular rupture. Loss of contour definition, heterogeneous echo pattern of the testicular parenchyma, and testicular hematoma showed a moderate to strong degree of correlation with testicular rupture (Spearman correlation co-efficient: 0.5–0.8). Over the past 30 years, the etiology of testicular injury changed from assault to falls or athletic injury and the severity of injury has decreased. Our findings demonstrate the importance of ultrasonography for determining an appropriate management strategy in scrotal trauma. Surgical exploration should be considered in patients with abnormal ultrasonographic findings.
Academies and Institutes ; Accidental Falls ; Athletic Injuries ; Hematoma ; Humans ; Korea* ; Medical Records ; Rupture ; Testis ; Ultrasonography

OBJECTIVETo explore the effect of burying testis in thigh pocket on spermatogenesis.

METHODSGuizhou miniature male pigs at child-bearing period were randomly divided to receive operation of scrotum incision and dissection with the testis burying in thigh pocket (experimental group) or without (control group). 3 months later, testis biopsy was performed on 2 pigs from each group for pathological examination. Then every male pig from both experimental (n = 6) and control group (n = 6) got a mating partner and lived together for 3 months. The fertility of the male pigs was observed. 6 months after operation, testis biopsy was performed again on all the animals from both the groups.

RESULTSBoth at 3 months and 6 months after operation, the pathological examination showed the spermatogenic cells of all stage in contorted seminiferous tubules markedly decreased with no mature sperm in experimental group, while normal spermatogenic cells with mature sperm in control group. After the male pigs lived with mating partners for 3 months, no female pigs staying with the experimental group became pregnant, but the male pigs in control group had a normal fertility.

CONCLUSIONSBurying testis in thigh pocket impedes spermatogenesis in the miniature male pig. So burying testis in thigh pocket is not recommended for patients with scrotum skin defect who wish to remain fertile.

Animals ; Female ; Fertility ; Male ; Pregnancy ; Pregnancy Rate ; Scrotum ; Skin ; injuries ; Spermatogenesis ; Swine ; Swine, Miniature ; Testis ; physiology ; Thigh ; surgery

Priapism is a relatively rare condition of prolonged painful penile erection, unrelated to sexual activity. It is caused by idiopathic, leukemia, sickle cell disease, oral medication, intracavernosal injection therapy, spinal cord injury and malignant cell infiltration. Malignant lymphoma involving the genitourinary system is uncommon and when it occurs the testes is the most common site. However malignant lymphoma involving the penis is even more rare, with only 20 cases reported in literature. To our knowledge, priapism caused by penile lymphoma has not been reported previously in literature. We report a case with a brief review of literature.
Anemia, Sickle Cell ; Leukemia ; Lymphoma* ; Male ; Penile Erection ; Penis ; Priapism* ; Sexual Behavior ; Spinal Cord Injuries ; Testis ; Urogenital System

PURPOSE: To investigate the effect of spinal cord injury(SCI) on male reproductive function, we evaluated changes of pituitary-testicular hormonal level at various time intervals in spinal cord injured rats. MATERIALS AND METHODS: SCI was produced in 30 sexually mature Sprague-Dawley rats by T10 spinal cord transection. 20 controls received similar surgery without transection. Testosterone concentrations in the serum and testis, serum levels of follicle-stimulating hormone(FSH) and leutenizing hormone(LH) were measured with radioimmunoassay. Two way analysis of variance(ANOVA) was performed. RESULTS: Testosterone levels in the serum and testis were lower at 2 weeks after injury than in controls, but others were not. Serum levels of FSH and LH were similar in both group. CONCLUSIONS: Spinal cord injury in rats induced impairment of testosterone production in testis at 2 weeks.
Animals ; Axis, Cervical Vertebra* ; Humans ; Male ; Radioimmunoassay ; Rats* ; Rats, Sprague-Dawley ; Spermatogenesis ; Spinal Cord Injuries* ; Spinal Cord* ; Testis ; Testosterone