Diagnostics and treatment of testicular trauma: the modern view on the problem

The paper presents the analysis of the up-to-date literature related to the diagnostics and emergency management of testicular trauma. The diagnostics is based on physical examination of the patient and ultrasound scanning of the organ injured. In case of testicular trauma, the sensitivity and specificity of scanning were 66.7% and 75%, respectively. In case of testicular rupture, revision of the testicle is recommended as soon as possible; the damaged tissues should be treated delicately. However, there are no exact recommendations regarding the choice of the method of reconstructive surgery. In case of testicle injury, surgical intervention is advised only in case of hematocele, whose volume is threefold higher than the contralateral testicle. In case of open testicle wounds, there is an absolute indication for testicle revision; in this case, the tactics of surgical intervention does not have any substantial differences, in comparison with the management of blunt trauma of the testicle. In case of surgical treatment of testicle trauma, the issue of antibacterial prophylaxis is not studied enough. The indications for the prophylaxis are not defined clearly enough for blunt trauma, although antibacterial therapy is reasonable in case of open wounds. Moreover, the paper reviews the modern advances in the field of semen cryoconservation, which is highly likely to save the fertility of a patient, even in case of a complete destruction of the testicular parenchyma.