Injuries to the testicle and epididymis are most often caused by a direct blow to the scrotum, compression during intercourse, or cold and firearms. In most cases, there is also an injury to the scrotum. Injuries are divided into closed, open, independent and combined. In closed lesions, a hematoma occurs in the scrotum and blood between the membranes of the testicle (hematocele). Closed damage to the testicle and the appendix. With great force of the impact, the testicle can be torn from the cordon. In certain cases, as a result of the trauma, the testicle can be displaced from its normal place. Disruption of blood supply can lead to disruption of spermatogenesis and testicular atrophy. The scrotum is enlarged, painful and with bluish-reddish skin. At the beginning, the testicle and epididymis are tense and very painful to palpation. Later, as a result of the large hematoma, their palpation becomes difficult, even impossible. Injury to the spermatic cord occurs with edema and hematoma in it, with contusions or rupture of the vas deferens and rupture or thrombosis of the vessels. Treatment In more severe cases, treatment is also aimed at combating collapse and shock. Depending on the finding, it is necessary to carry out the relevant surgical intervention in order to preserve the testicle. When surgery is not applied in time, testicular atrophy may occur. Overt injuries to the testicle and epididymis These injuries are more commonly caused by firearms and less commonly by cold weapons. The changes that may occur are determined by the type of traumatic factor and the degree of injury to the scrotum, testis, and epididymis. They can be tangential, penetrating and explosive. If the cord is injured, the testicle and epididymis may tear off. NEWS_MORE_BOX The clinic is similar to that of closed injuries. There is a wound with bleeding. Gunshot injuries occur with collapsed states and varying degrees of pronounced shock. Treatment Treatment for open injuries of the scrotal organs is initially reduced to fighting the shock state and stopping the bleeding. After that, surgical treatment of the wound is performed with clearing of necrotic tissues and hematoma, removal of foreign bodies and fine treatment of the testis while preserving its parenchyma. Removal of the testicle is performed when the cord is interrupted or its blood supply is significantly impaired.
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