Blunt scrotal trauma in adults: A multi-institution study evaluating the American Association for the Surgery of Trauma organ injury grading scale About 107 cases

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Published Dec 25, 2017
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Vol. 95 No. 5 (2017): Issue May 2017

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Sataa Sallami
Hassen Khouni
Hamza Ichaoui
Mahmoud Ben Atta
Sana Abou El Makarim
Sami Ben Rhouma

Abstract


Purpose: The authors evaluated the usefulness of the American Association for the Surgery of Trauma (AAST) testis injury scale based on preoperative scrotal ultrasonography (US) and physical examination compared to peroperative findings.
Methods: A retrospective review was performed on 107 patients (mean age=29,2±5.8 years) with a testis blunt trauma treated between January 2005 and August 2015. All patients underwent surgical scrotal exploration. Preoperative US was performed in all cases.
Testis trauma was classified according to the AAST organ injury scale, preoperatively based on physical examination and scrotal US and then compared to peroperative definitif grading scale.
Results: Of the included patients, 14 were found to have abnormal testis contours on US, 25 had a rupture of the tunica albuginea, with a sensitivity of 70,8% and a specificity of 71,2%.
Orchidectomy was performed in 12 cases, partial orchidectomy in 32 and tunica albuginea repair in 35 patients.
Conclusions: Through this series, US was not a specific and sensitive exam to really precise the severity grade of testis trauma. Pre- and preoperative findings were significantly different.
Thus, we continue to support history and clinical findings and we encourage surgical exploration when testis lesion is suspected.

Keywords:

Adult, testis, blunt trauma, rupture, hematoma, echography, classification, reconstruction, orchidectomy

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