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Forum Name: Urology Topics

Question: Permanent testicular rupture


 m_doc_l - Thu Jul 29, 2010 9:43 am

I accidentally hit my colleague(20 years) at his testicles, with hand(with a considerable force).
He was suffering from a severe pain for some time(1 hour), but then it reduced gradually.
He felt testicles are swollen for 2-3 days and he was feeling pain while touching it. But he was able to walk.
Without touching there was no pain after 1-2 days.
Pain gone completely after 1 week.
Do we need to suspect a permanent damage to testicles in this case?
Is there a possibility/incident where both testicles are damaged in such a hit?
 Dr.M.jagesh kamath - Thu Jul 29, 2010 12:28 pm

User avatar Hello,Trauma to the testis can be blunt,penetrative or avulsive types.Commonest are sports injuries leading to blunt injury.Absence of scrotal swelling and hematoma indicate generally a mild injury.
Mild cases are generally managed conservatively with scrotal support and pain relieving medication.
If the pain is out of proportion to the injury a scrotal sonogram is ordered to rule out testicular rupture.Doppler studies are done to study the status of blood vessels.Absence of vascularity could indicate testicular torsion,an emergency.
While nothing serious might have happened,still it should be assessed by your physician.
Best wishes.
 Dr.M.Aroon kamath - Thu Jul 29, 2010 12:39 pm

User avatar Hi,
Trauma can cause several complications related to the scrotal contents, including
- testicular rupture,
- intratesticular hematoma,
- testicular infarction,
- traumatic hematocele, and
- lacerations of tunica albuginea(the outer fibrous envelope of the testes).

Of course,trauma can cause bilateral testicular injury. Bilateral testicular infarction can result in atrophy of the testes.Unilateral testicular atrophy is less of a problem,as the remaining testis(if healthy), can look after adequate spermatogesis as well as endocrine functions.

Testicular trauma, if minor, may only cause transient excruciating pain and nothing more.More severe forces may result in the aforesaid complications.

A scrotal ultrasound examination with color doppler(duplex ultrasonography) is the best way to exclude trauma to the scrotal contents.

To get over the anxiety and speculation, you must show your colleague to a urologist and get investigated.
Best wishes!
 Dr.M.Aroon kamath - Thu Jul 29, 2010 12:41 pm

User avatar Hi,
There is one other aspect which i would like to mention. At times, although the pain might have subsided, monor tears of the tunica albugenia are possible and tenderness may remain. Small hematoceles may also be easily overlooked. Therefore, it is best to get investigated all the same.
Good luck!
 m_doc_l - Fri Jul 30, 2010 9:12 am

Dear Dr. Jagesh Kamath and Dr. Aroon Kamath, thank you for your valubale replies.

This incident happened around 5 years back. Though I urged my colleague to get investigated by a physician at that time, he did not agree.
I don't know why suddenly I am worried about this now.....
I understand, now we can only investigate, but no solutions if anything serious happened, since it is delayed too much..
But one question, will there be no physical symptoms in case both testis damaged permanently? I mean, any symptoms in a long run (not the pain felt immediately after the injury). Can it happen for person doesn't come to know about a testis damage for such a long time?
 Dr.M.Aroon kamath - Sat Aug 07, 2010 10:30 pm

User avatar Hi,
Testis has 2 main functions,
- exocrine (spermatogenesis) and
- endocrine (hormonal).

Although, it is well known that testicular trauma has the potential to cause testicular infarction and atrophy and thus affect the exocrine and endocrine functions of the testis adversely, the long-term effects of testicular trauma on reproductive function are surprisingly unknown.There is a paucity of studies on long term complications of testicular trauma.

One isolated study concludes thus;
"There was definite evidence of subfertility as assessed by abnormal semen analyses and atrophic testes following testicular trauma. However, the subfertility did not appear to be immune mediated nor did the patients present with infertility. We conclude that early repair can help preserve hormonal function as well as fertility".
The Journal Of Urology,
"Testicular Trauma: Potential Impact on Reproductive Function"
Volume 156, Issue 5, Pages 1643-1646 (November 1996).
Best wishes!

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