Accuracy of ultrasonography in diagnosis of testicular rupture after blunt scrotal trauma.
OBJECTIVE
The aim of this study is to determine the accuracy of ultrasonography for the diagnosis of testis rupture after scrotal trauma and its sensitivity and specificity for testis rupture, tunica albuginea breach, testicular hematoma, testis avulsion, epididymis injuries, and hematocele.


METHODS
Between 1996 and 2006, 33 patients underwent surgical exploration for blunt scrotal trauma. All these patients had an emergency scrotal ultrasonography with the use of a 7.5 or 10 MHz linear transducer. Ultrasonographic findings were compared with surgical findings to calculate sensitivity and specificity of ultrasonography for each type of lesion.


RESULTS
Of 33 patients, 16 presented a testis rupture. Testis rupture was in all cases suspected ultrasonographically by the loss of contour of the testis and heterogeneous parenchyma. Tunica albuginea breach was visualized in only 8 patients. Sensitivity and specificity of ultrasound for testis rupture were 100% and 65%, respectively. Moreover, ultrasonography allowed diagnosis of hematocele (sensitivity: 87% and specificity: 89%), testicular hematoma (sensitivity: 71%, specificity: 77%), and testis avulsion (sensitivity: 100%, specificity: 97%). Ultrasonography results for epididymis injuries were poor. On 7 patients, 3 epididymis lesions were misdiagnosed by ultrasound examination.


CONCLUSIONS
Ultrasonography can distinguish various scrotal injuries. Testicular rupture is probably the most severe injury that needs early surgical treatment to improve testis salvage rate. In our work, ultrasonography is highly sensitive in the diagnosis of testis rupture and can provide information on the scrotal contents integrity that can help the physician to determine the optimal treatment.
Guichard
Guillaume
G
Department of Urology, University Hospital of Besançon, Besançon, France.
El Ammari
Jamal
J
Del Coro
Carlos
C
Cellarier
Damien
D
Loock
Pierre Yves
PY
Chabannes
Eric
E
Bernardini
Stéphane
S
Bittard
Hugues
H
Kleinclauss
François
F
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006398:Hematocele / Q000000981:diagnostic imaging / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009919:Orchiectomy; D012189:Retrospective Studies; D012421:Rupture; D012611:Scrotum / Q000293:injuries*; D012680:Sensitivity and Specificity; D013737:Testis / Q000000981:diagnostic imaging / Q000293:injuries*; D014463:Ultrasonography; D014949:Wounds, Nonpenetrating / Q000150:complications / Q000000981:diagnostic imaging*