Management of trauma to the male external genitalia: the usefulness of American Association for the Surgery of Trauma organ injury scales.
OBJECTIVE
Injury to the male external genitalia is rare and, therefore, there are little data in the literature regarding the options for nonoperative management and outcome. To assist in defining the indications for nonoperative management the usefulness of the American Association for the Surgery of Trauma (AAST) organ injury scales for these injuries was examined.


METHODS
We retrospectively reviewed the medical records of 116 male patients with trauma to the external genitalia in a 10-year period and classified injuries according to the organ injury severity scales (scrotum, testis, penis and urethra) of the AAST. Based on AAST grading management and outcome was reviewed.


RESULTS
Mean patient age was 28 years and 79% of the injuries were due to gunshot wounds. A total of 87 patients (75%) underwent surgery, while 27 penile injuries and 8 scrotal/testicular injuries were managed nonoperatively. There were 54 scrotal explorations, 33 testicular injuries and 20 orchiectomies (bilateral in 1) for a testicular salvage rate of 39%. Documented followup by the trauma or genitourinary service was achieved in 47 of 110 survivors. No patient reported impotence or difficulty with fertility.


CONCLUSIONS
The AAST grading for male external genital trauma readily characterizes patients with high grade injuries that require operative management as well as select patients in whom injury can be safely managed nonoperatively.
Mohr
Alicia M
AM
Department of Surgery, University of Medicine and Dentistry of New Jersey-New Jersey Medical School, Newark 07103, USA. mohr@umdnj.edu
Pham
Annette M
AM
Lavery
Robert F
RF
Sifri
Ziad
Z
Bargman
Vladislav
V
Livingston
David H
DH
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D005837:Genitalia, Male / Q000293:injuries* / Q000601:surgery; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D010413:Penis / Q000293:injuries; D017410:Practice Guidelines as Topic; D012189:Retrospective Studies; D012611:Scrotum / Q000293:injuries; D013737:Testis / Q000293:injuries; D014521:Urethra / Q000293:injuries; D013521:Urologic Surgical Procedures, Male