Testicular rupture and discharge

After the testicle is broken, water discharge will occur, accompanied by clinical symptoms of swelling and pain. This requires immediate hospitalization for a detailed examination to determine whether it is caused by testicular damage. If it is confirmed to be testicular damage, testicular repair surgery must be performed in time, otherwise it will affect the normal life of male friends in the future, and even affect fertility.

Scrotal injuries are divided into two categories: open and closed. Open injuries can be caused by firearms, knife cuts, punctures, lacerations or avulsions. Firearm injuries can cause scrotal skin to be broken or missing, and are often accompanied by damage to scrotal contents such as the testicles and spermatic cord, which are more serious. Closed injuries often occur in sports injuries, riding injuries and kicking injuries. The mildest cases are just simple contusions, while the most severe cases may cause hematomas and testicular rupture. Hematomas can occur in the soft tissue of the scrotal wall or in the tunica vaginalis of the testis, forming hemocele. Since the testicles are wrapped in the scrotum, it usually manifests as scrotal injury and is not easily taken seriously.

Hematoma and pain make it difficult to determine whether there is scrotal content, especially testicular injury, during physical examination, which can easily delay diagnosis and treatment. If there is bleeding in the testicular tunica albuginea or large hematoma in the scrotum, local high pressure may occur, resulting in testicular atrophy in the following days; bilateral testicular injury is more likely to ignore the treatment of the side with milder symptoms; if one side of the testicular injury is not properly treated, the hematoma caused by testicular rupture may lead to secondary infection and exposure of sperm antigens, which may easily be attacked by the autoimmune system, causing atrophy of the healthy testicle, which may seriously affect sexual function or even infertility. Therefore, both closed and open scrotal injuries should be alert to the presence of testicular injury and be actively treated.

B-ultrasound diagnosis of testicular injury can accurately determine whether it is simple scrotal hematoma or testicular rupture, whether the testicular tunica albuginea is intact, and whether there is testicular tissue protruding outside the tunica albuginea, so as to determine whether surgical treatment is necessary. When blood clots have not formed or the hematoma is not large, B-ultrasound is more accurate in judging the state of the testicles, so it should be performed within 24 hours after injury.

The scrotal skin is highly elastic, has abundant blood circulation, and has strong healing ability. In the initial treatment of open wounds, the wound should be thoroughly cleaned and the inactive tissue should be trimmed, and sutured in situ as much as possible to cover the contents of the scrotum. If it is impossible to cover, the testicles and spermatic cord can be buried in the subcutaneous tissue of the inner thigh, and scrotal reconstruction can be performed 3 to 6 weeks later, or scrotal reconstruction can be performed immediately after debridement to restore the testicles to the reconstructed scrotum.

After excluding testicular trauma, if the hemorrhage is not large, intermittent puncture can be used to drain the blood to reduce the pressure in the tunica vaginalis and wait for it to be absorbed. If the hematoma is large and the pressure in the tunica vaginalis is high, the blood should be drained and the testicles should be examined in time. If the testicular rupture is large or fragmented, partial orchiectomy can be performed to preserve the vital testicular tissue as much as possible.