暂无摘要。

UNASSIGNED: Testicular loss following assault is a very rare occurrence and uncommon in the low income countries. Testicular amputation is usually associated with blast injuries, sexual violence and self-mutilation in psychiatric cases. Management involves a multidisciplinary approach and is focused on resuscitation, aggressive debridement, testosterone supplementation, and reconstructive surgery.
METHODS: We present a 31 year old male referred to the emergency department of a Regional Referral Hospital in western Uganda with a history of trauma to his scrotum. The patient had been well till 16 h prior to presentation when he was attacked by unknown assailants who broke into his house in the night. The patient was reportedly beaten before his scrotum was pulled and amputated with eventual profuse bleeding. Evacuation of approximately 150 cc hematoma was done plus debridement of necrotic testes and achieving hemostasis.
CONCLUSIONS: To the best of our knowledge, this was the first reported case of bilateral traumatic testicular amputation as a result of assault. Revascularization with micro-vascular techniques can be done if the patient presents early, but due to late presentation, the patient was only managed with aggressive debridement, reconstruction and testosterone supplementation.

Although there are some reports describing foreign body implantation into the penis by intentional manipulation, no records about patients got aware of it many years after traffic accidents. A 29-year-old male patient had been severely injured in a traffic accident 13 years ago. Following a coma state for several months, he had no any symptom for a long time. Four years later, he got aware of the inconvenience on the ventral side of his penis during erection. His partner had also complained of pain during coitus. When he was admitted to our clinic, there was a semi-mobile, fibrous dense 2x2 cm knob on the ventral side of the penis consisting of a coronal sulcus. Under local anesthesia, we got out of a piece of glass. He was discharged after enough follow-up periods without complication. The interesting point of this case was not the clinical condition of the patient; it was that no one could consider a coma patient would have a complaint of penis injury several years later. This case showed us, one more time, how important the complete physical examination was.

We present 3 male patients with genital bruising due to physical abuse to improve recognition of genital trauma as a sentinel injury. In the absence of an underlying medical condition or a clear acceptable accidental mechanism for the genital injury, an evaluation for child abuse is recommended.

We report the case of a patient with massive penile and scrotal swelling due to use of a compression ring with auto-erotic intent and under the influence of addictive substances. Based on the patient history, the mechanical pressure on the scrotum was about 30 hours (h). The Doppler sonogram showed no central perfusion in either testicle. Conservative treatment with antibiotics and analgesics was initiated with a slight increase in inflammatory parameters and local edema and necrosis formation. Follow-up showed regression of swelling, healing of necrosis and improvement of laboratory parameters. Testosterone substitution therapy was necessary due to the bilateral testicular atrophy that developed.
UNASSIGNED: Es handelt sich um einen Fallbericht einer massiven Penis- und Skrotalschwellung durch Anlegen eines Dichtungsringes in autoerotischer Absicht unter erheblichem Suchtmittelkonsum. Der mechanische Druck auf das Skrotum lag anamnestisch bei ca. 30 Stunden (h). Beide Hoden waren dopplersonographisch ohne zentrale Perfusion. Eine konservative Therapie mit Antibiose und Analgetika wurde bei dezenter Erhöhung der Entzündungsparameter und lokaler Ödembildung und Nekrosebildung eingeleitet. Im Verlauf zeigten sich eine rückläufige Schwellung, Abheilung der Nekrosen und Besserung der Laborparameter. Die Ausbildung einer Hodenatrophie beidseits erforderte die Notwendigkeit der Testosteronsubstitutionstherapie.

暂无摘要。

Male external genitalia injury with testicular loss is relatively uncommon in civilian practice. Testicular amputation is usually found with military trauma and self-mutilation. However, they do occur while operating machines for domestic purposes. The standard protocols for the management of traumatic testicular amputation are lacking. The management is focused on resuscitation of the patient and restoration of testicular function with acceptable cosmesis. Here, we present a case of a 45-year-old man with traumatic right testicular amputation while he was using a thresher for rice cutting.

Gunshot wounds (GSW) to the penis and scrotum are present in two thirds of all genitourinary (GU) trauma, with a growing proportion of blast injuries in the military setting. Depending on the energy of the projectile, the injury patterns present differently for military and civilian GSWs. In this review, we sought to provide a detailed overview of GSWs to the external genitalia, from mechanisms to management. We examine how ballistic injury impacts tissues, as well as the types of injuries that occur, and how to assess these injuries to the external genitalia. If there is concern for injury to the deep structures of the penis or scrotum, operative exploration and repair is warranted. Relevant history and physical examination, role of imaging, and choice of conservative or surgical treatment options in the civilian and military setting are discussed, as well as guidelines for management set forth by the American Urological Association (AUA) and European Association of Urology (EAU).

暂无摘要。

OBJECTIVE: To determine the utility of a 3D vulvar model for teaching pediatric straddle injury repair.
METHODS: Prospective study.
METHODS: Two academic hospitals.
METHODS: Twenty obstetrics and gynecology residents INTERVENTIONS AND MAIN OUTCOME MEASURES: Knowledge score on the basis of a 7-question pre/post test. Likert scale questions evaluated the 3D model as a teaching tool.
RESULTS: Twenty residents participated; 2 (10%) had ever repaired a straddle injury. Knowledge scores increased after model use and didactic session from 3.05 of possible 7 to 6.35; P = .001. Only 2/20 (10%) residents \"agreed\" or \"strongly agreed\" with the statement, \"I am comfortable repairing a straddle injury\" before the intervention, compared with 19/20 (95%) afterward (P < .001). Of 20 residents, 19 (95%) believed that it simulated surgical experience \"very well\" or \"well.\"
CONCLUSIONS: The use of a 3D pediatric vulvar model can simulate surgical experience and can be an effective teaching tool when combined with a didactic session on pediatric straddle injury.