Penile subcutaneous hemorrhage

Men should take care to protect their penis, especially when exercising, to avoid injury. When subcutaneous congestion of the penis occurs, pay attention to whether it is caused by improper exercise posture, which is very common. Penile trauma mostly occurs in young and middle-aged people, and is often caused by carelessness, but if it is not recovered in time, it will affect future fertility.

Male external genitalia are exposed to the outside of the body and are susceptible to trauma in confrontational sports, war, improper sexual intercourse, etc. Male genital trauma mainly occurs in young and middle-aged people, which not only affects the health of the patient, but is also likely to affect reproductive function. Based on the integrity of the skin, it is divided into closed injuries and open injuries. Common closed injuries include penile skin contusion, penile fracture, penile strangulation, penile dislocation, testicular rupture, testicular ectopicness, and scrotal subcutaneous hematoma; common open injuries include penile cutting, penile separation, penile skin laceration, scrotal skin laceration, and damage to the contents.

treatment

1. Penile trauma

(1) For penile skin contusions, first apply cold compresses and then hot compresses. If there is obvious hemorrhage, drainage can be performed by suction or incision.

(2) Debridement, hemostasis, and suturing of penile skin lacerations. If the skin is extensive, debridement and skin grafting may be performed. Attention should be paid to protecting the erectile function of the penis. Anti-infection treatment should be given after the operation.

(3) If there is penile stenosis, remove the stenosis immediately to improve local blood circulation.

(4) Debridement of penile dislocation, removal of hematoma, surgical reduction, fixation of the penis to its normal position and placement of a urinary catheter.

(5) Minor cases of penile fracture are treated conservatively: analgesia, cold compress, bandage and compression, oral hemostatics and female hormones, and antibacterial drugs; severe cases require surgery: removal of hematoma, complete hemostasis, and suture of ruptured tunica albuginea.

(6) If the distal penis is intact and the injury is recent, microsurgical reimplantation can be performed after debridement.

2. Scrotal and testicular trauma

(1) For open injuries, simple scrotal lacerations without infection should be cleaned and sutured as soon as possible. For severe scrotal lacerations and penetrating injuries, the wounds must be cleaned thoroughly, the dead tissue must be cut off, and as much residual scrotal skin as possible must be retained so that it can cover the exposed testicles. If the scrotal skin is more damaged and difficult to repair, the scrotum can be reconstructed by transferring a skin flap, or the testicles can be temporarily buried under the skin of the inner thigh, and the testicles can be returned to the scrotum after a second-stage scrotoplasty.

For testicular rupture, the wound is cleaned thoroughly, necrotic tissue is cut off, testicular tissue is preserved to the maximum extent, the tear of the testicular tunica albuginea is sutured, and scrotal drainage is performed. If the testicle is extensively ruptured or blood supply is lost, the testicle can be removed.

Antimicrobial drugs should be used after surgery to prevent infection.

(2) Closed injuries ① Rest in bed for scrotal and testicular contusions, elevate the scrotum, apply cold compresses first and then hot compresses to absorb the blood stasis, and give antibiotics to prevent infection. ② Scrotal hematoma Small hematoma can be treated with scrotal support, local pressure and cold compresses; if the hematoma is large and gradually worsens, it should be treated surgically, during which blood clots should be removed, bleeding should be stopped completely, and anti-infection treatment should be performed; if infection is combined with abscess formation, drainage should be performed by incision. ③ Hemocele Hemocele is intracerebrospinal bleeding, and it should be treated as hydrocele in the early stage. If there is chronic inflammation, the cerebellum is thickened and hardened, a celectomy can be performed. ④ Hematoma and organization After hemocele, the hematoma and organization are similar in shape and hardness to the tumor-like organized mass, which presses on the testicles and causes atrophy of the testicular tissue. Surgical resection should be adopted for treatment.