Comparison of the Testicular Salvage Rate according to Treatment Method in Scrotal Trauma

ABSTRACT

PURPOSE: The purpose of this study was to compare the testicular salvage rate, visual analogue pain scale, and hospital stay according to treatment method in patients with scrotal trauma. MATERIALS AND METHODS: We retrospectively reviewed the medical records of 103 patients who visited the emergency department with scrotal trauma between January 1996 and February 2009. Treatment methods for scrotal trauma were divided into four groups (total orchiectomy, partial orchiectomy, simple suture, and conservative treatment) for patients with testicular rupture and two groups (exploration and hematoma evacuation, conservative treatment) for patients with scrotal hematoma. We analyzed the testicular salvage rate, visual analogue pain scale, and hospital stay of each group. RESULTS: The study included 58 patients with testicular rupture and 45 patients with a scrotal hematoma. The patients' mean age was 26.8 years, and most cases occurred during the second decade of life. The main cause of scrotal trauma was assault, which included 41 cases (39.8%). Immediate surgical intervention for testicular rupture improved the testicular salvage rate, reduced the duration of hospital stay, and was associated with less pain. For patients who underwent partial orchiectomy and conservative management, the length of hospital stay and the reported pain were greater than for patients who had total orchiectomy and simple suturing. In addition, the testicular salvage rate in patients who underwent a partial orchiectomy or conservative management was lower than in cases with simple suturing. For scrotal hematoma, the testicular salvage rate in patients who underwent exploration and hematoma evacuation was 100%. CONCLUSIONS: Because the testicular rupture patients treated by partial orchiectomy showed worse results than did the patients treated by other methods, a patient's status such as age, marital status, and number of children need to be carefully considered before a decision is made to perform a partial orchiectomy. For scrotal hematoma, patients treated by exploration and hematoma evacuation exhibited a higher testicular salvage rate than did patients treated with conservative management.