Unilateral Traumatic Testicular Dislocation in a Patient of Pelvic Diastasis and Spine Fracture in an Adult: A Case Report and Review of Literature.

Introduction: With advancement, the occurrence of road traffic accidents is common. Timely management of fractures of the spine and pelvis is of the utmost importance for survival, ambulation, and maintenance of normal life. Genitourinary complications following pelvic ring injuries are not unknown; however, testicular dislocation is rare and can cause significant morbidity if not managed appropriately. Case Report: Our case was a 25-year-old male who was presented to the tertiary trauma center following a motorcycle accident. He had an anteroposterior compression (APC) fracture of the pelvic ring (APC-III, Arbeitsgemeinschaft für Osteosynthesefragen 61-C1.2), D8-D9 vertebra compression fracture, fracture of the left distal radius, and radio-carpal dislocation. However, no concomitant genitourinary injury was noticed at the initial assessment. After resuscitation, the pelvis was planned to be fixed with an anterior symphyseal plate and posterior sacroiliac joint fixation using 2 cancellous screws. While using Stoppa's approach, surprisingly, the right testicle was observed to be inferior to the pubis. Trauma surgery help was sought and the dislocated testis was reduced and managed with orchidopexy after checking the viability. At the follow-up of 1 year,the pelvic fracture was united without urogenital complication. Conclusion: In cases of complex pelvic ring injury, a careful genital examination should be performed and a multi-disciplinary team approach with compromising of radiology, traumatology, and orthopedics departments should be adopted for better patient outcomes.

Bilateral traumatic testicular dislocation after motorbike accident: A case report with literature review.

The occurrence of testicular dislocation resulting from blunt trauma to the scrotum or abdominopelvic region is infrequent. Due to the presence of significant associated injuries, the diagnosis of this condition can often be missed. This case study presents a case of an adult male who experienced bilateral testicular dislocation following a motorbike accident. Additionally, a concise review of relevant literature is included.

Penile traumatic testicular dislocation: a case report.

Traumatic testicular dislocation is rare and usually occurs in patients after a traumatic motor accident. Manual reduction or surgical exploration is the main treatment for this condition. We report a rare case of unilateral traumatic testicular dislocation in a man with an ectopic testis in the middle of the penis after a motorcycle crash injury. On the sixth day of hospitalization, the patient found a lump in the middle of his penis. Doppler ultrasound showed an ectopic testicle in the middle of the penis with good blood flow. After consultation, a manual reduction was successfully performed. A careful physical examination should be performed in patients with multiple injuries from the first medical exam. Early detection and timely reduction are critical to protect testicular function.

Fatal motorcycle straddle injury consolidated with traumatic testicular dislocation: A case report.

Straddle injuries are those to the perineum region brought on by straddling or riding over something, such as a horse, vehicle, or other object. The motorcycle fuel tank or handlebars are primarily responsible for the typical injury to the perineum area in motorcycle accidents. Motorcycle straddle injury usually manifest as abrasions to the scrotum or penis, and severe cases can cause pelvic fractures or even testicular dislocation. Because these injuries are usually closed with unclear internal damage, diagnosis presents a significant challenge and can easily lead to misdiagnosis. However, pelvic fractures and the bleeding and nerve damage associated with perineal injury are often fatal, and testicular dislocation can also have serious consequences for patients. Therefore, a clear diagnosis and timely treatment are crucial for patients with this type of injury. This article reports the case of a motorcycle rider who died 4 h after a traffic accident with only minor surface injury visible, showing only bruising in the waist and scrotum. A forensic examination revealed multiple fractures throughout the patient's body, with a slightly more severe pelvic fracture and testicular dislocation on the left side in the left inguinal area. This article analyzes the cause of death and related issues in this case, aiming to provide assistance to clinical physicians and forensic practitioners and to emphasize the importance of handling straddle injury in treatment and related investigations to avoid serious consequences.

A Rare and Easily Overlooked Case of Bilateral Traumatic Testicular Dislocation and an Alternative Viewpoint on Delayed Management.

The incidence of traumatic testicular dislocation is rare, and it is usually overlooked in an initial diagnosis. We present a case of bilateral dislocated testes after a traffic accident that was treated via orchidopexy one week later. No testicular complications had occurred by the time of the follow-up visit. Generally, surgery is often postponed owing to a late diagnosis or another major organ injury, and the adequate timing of surgery is still under debate. We performed a review of past cases, which showed similar testicular outcomes irrespective of surgical timing. Delayed intervention may be a feasible decision after a patient's hemodynamic status is stable for surgery. To prevent delayed diagnosis, scrotal examination should not be overlooked in any patients presenting with pelvic trauma to the emergency department.

Pediatric testicular posttraumatic dislocation presenting as a testicular torsion: A case report.

Traumatic dislocation of the testicle is a rare complication that occurs after blunt trauma to the scrotum or abdominopelvic injury. The majority of cases occur in young adults following severe scrotal trauma in a motorcycle accident. We report the case of a 1.5-year-old infant admitted for left scrotal swelling with a left inguinal mass. Ultrasound and Doppler examination showed a twisted necrotic testicle with inguinal adenopathy. Surgical exploration in the emergency room confirmed that the inguinal mass was a dislocated testicle with an intrascrotal hematoma that was evacuated followed by orchidopexy of the dislocated testicle.

Adnexal smooth muscle hyperplasia resulting in non-traumatic testicular dislocation: A case report.

Tumors of the para-testicular adnexa are very rare and are typically histologically diagnosed as adenomatoid neoplasms, leiomyomata, or smooth muscle hyperplasia. Though these masses are usually benign, the potential for malignancy and mass effect causing intrascrotal discomfort necessitate proper diagnosis and excision. Herein, we describe a unique case of gradual, atraumatic testicular dislocation in a 40-year-old male caused by smooth muscle hyperplasia of the testicular adnexa affecting the epididymis and vas deferens. This case highlights the diagnostic and surgical challenges associated with this presentation.

A Literature Review and Two Case Reports: Is Traumatic Dislocation of the Testes a Surgical Emergency?

Traumatic dislocation of the testes (TDT) is a rare sequela of blunt scrotal and perineal trauma. TDT can easily be overlooked during concomitant trauma due to other injuries, The damage to the testis appears to be not severe in dislocation and may be corrected by repositioning even if it is delayed. However, delayed intervention might be associated with pain and discomfort and may lead to abnormal sperm parameters and possible infertility. The urgency of surgical intervention increases whenever there is associated testicular torsion, rupture, or bilateral testicular TDT. We report two cases of unilateral traumatic testicular dislocation following motorcycle crashes with different presentations and approaches to treatment. We also engage in a review of the relevant literature.

Traumatic superficial testicular dislocation and manual reduction guided by ultrasound: a case report / 中华泌尿外科杂志

Testicular dislocation is a rare clinical presentation that occurs most commonly as a result of blunt scrotal injury or abdominopelvic injury. In this study, a rare case of testicular dislocation was reported, who was a 65-year-old man presented with a right testicle squeezed into the subcutaneous penis, and a good recovery after a successful manual restoration under ultrasound guidance was achieved. The treatment of testicular dislocation is mostly surgical, but ultrasound-guided manual restoration may provide a feasible treatment for patients with superficial dislocation based on this case report.

Delayed Diagnosis and Treatment of Traumatic Testicular Dislocation: A Case Report and Literature Review.

Traumatic testicular dislocation is a rare complication secondary to different kinds of accidents. A 61-year-old man, who was injured by wall collapse and was diagnosed as pelvic fracture and posterior urethral rupture 5 months ago, came to the urologic department to seek urethral reconstruction. However, thorough physical examination and imaging examination confirmed a round mass in the right inguinal region and an empty right scrotum, which support diagnosis of testicular dislocation. The patient did not take the initiative to complain about that because he thought the right testis had been destroyed by the accident already. So the patient underwent fiber cystourethroscopy, urethral reconstruction, and orchiopexy. No testicular atrophy was confirmed at follow-up. We reviewed previous reports about traumatic testicular dislocation and analyzed the cause of delayed diagnosis.

Pelvic Fracture Associated with Intrapelvic Dislocation of Testis.

INTRODUCTION: Intrapelvic testicular dislocation is rare injury with the possibility of missed or delayed diagnosis. Timely diagnosis of intrapelvic testicular dislocation can prevent iatrogenic testicular injury during surgery and its long-term sequel. CASE REPORT: A 30-year-old male after motorbike accident presented with a pelvic injury with intrapelvic dislocation of testis. Timely and appropriate diagnosis of injuries, specially intrapelvic dislocation of testis, required early orchidopexy and open reduction and internal fixation of the anterior column, leading to excellent outcome. CONCLUSION: In cases of polytrauma and pelvic injuries specially motorbike accidents, testicular dislocation should be ruled out before definitive surgery. Adequate communication and co-ordination between orthopedic surgeon, radiologist, and urologist can lead to excellent outcomes.

Testicular Dislocation After Unstable Pelvic Ring Injury.

Reproductive and genitourinary complications following pelvic ring injuries have been described; however, testicular dislocation is rare and can cause significant morbidity if not managed appropriately. We describe a case of testicular dislocation after pelvic ring injury and outline the subsequent management and outcome, and seek to identify areas of improvement to ensure expedient and appropriate care in the setting of these injuries. Our case describes a 29-year-old male who presented to a level-one trauma center following a motorcycle collision. An anteroposterior compression type II rotationally unstable pelvic ring was identified on imaging. He was hemodynamically unstable and computed tomography (CT) with angiography was ordered. Arterial extravasation was noted from the bilateral anterior internal iliac arteries, which were subsequently embolized by interventional radiology. However, no concomitant genitourinary injury was identified at the time of CT. After resuscitation, the pelvis was stabilized with an anterior symphyseal plate and bilateral sacroiliac screws. During the anterior pelvic approach, the patient's dislocated testicle was surprisingly discovered inferior to the pubis. Urology was consulted intra-operatively, and the testicle was successfully relocated. At the final follow-up, the pelvic ring was healed without any noticeable urogenital complication. While testicular dislocation has been reported in the setting of pelvic ring injury, a paucity of information exists regarding management, implications, and areas for improvement in the identification of these injuries. Therefore, in cases of pelvic ring injury with significant trauma, radiologists, traumatologists, and orthopedic surgeons should adopt a multi-disciplinary approach in diligently attempting to rule out testicular dislocation pre-operatively. Intra-operatively, examination under anesthesia and careful operative technique are important in preventing iatrogenic injury.

Testicular dislocation: An atypical case and review of the literature.

Traumatic dislocation of testis is a rare event. We report a case of traumatic testicular dislocation in a 27-year-old patient presenting a right inguinal lump in a context of acute alcohol abuse with transient global amnesia. There was a tender mass in the right inguinal region and right hemiscrotum. He ascertained a previous scrotal position of both testes. The Doppler ultrasound confirmed the diagnosis of a dislocated right testis in right inguinal canal and surgical reduction and orchidopexy was performed. It is necessary to perform a complete physical examination in a trauma patient, early detection and management are both essential to preserve normal spermatogenic function.

Conservative management of bilateral traumatic testicular dislocation in a 10-year-old boy.

A 10-year-old boy fell from a one-meter-high Jacuzzi ladder in a hot spring facility, landing in a straddle position, and injured his perineum. He visited the emergency room of our hospital immediately after the injury. Magnetic resonance imaging (MRI) revealed a tear of the corpus spongiosum urethra, and compression due to a hematoma. With the hematoma spreading to the scrotum, the testes became inverted and dislocated to the inguinal region on both sides. Without surgery or interventions, the testes descended into the scrotum on the third day after the injury before fibrillation and scarring began. Testicular dislocation by injury is rare and encountered exclusively in children. It is generally treated with surgery to retain testicular function. We selected conservative management, as our patient had a closed injury without testicular torsion, and the testicular dislocation was associated with compression by hematoma, which could possibly recover with regression of the hematoma.

Conservative management of bilateral traumatic testicular dislocation in a 10-year-old boy / Journal of Rural Medicine

A 10-year-old boy fell from a one-meter-high Jacuzzi ladder in a hot spring facility, landing in a straddle position, and injured his perineum. He visited the emergency room of our hospital immediately after the injury. Magnetic resonance imaging (MRI) revealed a tear of the corpus spongiosum urethra, and compression due to a hematoma. With the hematoma spreading to the scrotum, the testes became inverted and dislocated to the inguinal region on both sides. Without surgery or interventions, the testes descended into the scrotum on the third day after the injury before fibrillation and scarring began. Testicular dislocation by injury is rare and encountered exclusively in children. It is generally treated with surgery to retain testicular function. We selected conservative management, as our patient had a closed injury without testicular torsion, and the testicular dislocation was associated with compression by hematoma, which could possibly recover with regression of the hematoma.

Perspectives in Pediatric Pathology, Chapter 23. Testicular Pathology Secondary to Physical and Chemical Injury.

Testicles can be damaged by a variety of physical and chemical agents, ranging from trauma suffered in accidents or athletic activities, to diverse drugs or radiation used in cancer treatment. The immediate and long-term effects of these damaging agents at the testicular morphologic and functional levels are quite varied and may have significant impact on the fertility of the pediatric patient once reproductive age is reached.

Traumatic testicular dislocation after minor trauma in a pediatric patient.

BACKGROUND: Traumatic dislocation of the testicle is a rare injury that may result from blunt abdominopelvic trauma. The majority of cases reportedly occur in young adults secondary to severe scrotal trauma during high-speed motorcycle crashes. Our review of the available English medical literature revealed only one pediatric case. OBJECTIVE: We present a case of pediatric testicular dislocation and torsion resulting from minor abdominopelvic trauma. The case report is followed by a brief review of the available literature. CASE REPORT: A 10-year-old boy presented to the Pediatric Emergency Department with abdominal pain. He had suffered a strike to the abdomen and groin during an attempt at flipping over a "monkey bar" at school. A tender mass was found in his right inguinal canal and the genital examination revealed an empty right hemiscrotum. Bedside ultrasonography was used to locate the testicle and it was noted by color-flow Doppler to lack demonstrable blood flow. The patient was taken emergently to the operating room, where he underwent orchiopexy and hernia repair after a viable testicle was found. He had a subsequently uneventful recovery. CONCLUSION: Although rare, testicular dislocation may be a serious result of abdominopelvic trauma. Emergency providers who care for trauma patients must include this condition in their differential diagnosis; to do otherwise risks a delay in diagnosis that may affect testicular viability. In this case, testicular dislocation may have resulted from the combination of trauma and a previously undiagnosed indirect inguinal hernia.