Introduction and Objectives
To analyze testicular injuries, causes and consequences, especially threes influence on fertility and to asses threes medico legal significance.
Material and Methods
57 patients, hospitalized and surgically treated, from January 1999 to December 2008, on urological department of KCS Belgrade. During hospitalization patients were physically examined, lab. Work and scrotal ultrasound were performed. On evident rupture or suspected rupture, we performed surgical exploration. Dependent on the findings, we performed orchyectomy or conservation of the testis. Procedure independently, every patient interested in his fertility was check out on 1, 3, 6 and 12 months, examined physically, scrotal ultrasound and spermogram. Results were statistically analyzed and schematically displayed.
Patients age was between 14 and 74 years (X = 35; DS = 14.45) closed injury we found in 40 (70%) patients and opened injury we found in 17 (30%) patients. Causes of closed injuries were sport activities, fights, occupational injuries 50%, 42.5% and 7.5% respectively Causes of opened injuries were shot guns 6 (35%)self injuries, castration were found in 3 (17.5%) in psychological patients. In the rest of 8 (47.5%)opened injuries we found different accidents, motorbike accidents, dog bites, occupational injuries, fall on spiky object, jumping over the fence etc. 28 patients under the age of 40, childless or interested in having more children were interested in regular checkups during the following year on 1, 3, 6 and 12 months. 15 of which (no matter what kind of injury they suffered) had a good spermogram results. 13 patients, initially having a spermogram results below the usual finding, the number of spermatozoids, their shape and motility, during next 6 check ups, 3 and 6 months, have improved there sprmogram results so that on 12-th months examination, they had normal findings. The rest of 7 patients, unfortunately, suffered a bad spermogram finding, even when we performed other tests, hormonal analysis (FSH, LH, PL, and T0 so to exclude other possible causes of these findings
Testicular injuries, leading to loss of testis or surgically repaired, conserving tests, may lead to male infertility. This condition may be transient but may have a long term consequences. Since great number of these injuries were fight afflicted, guns afflicted, sport injuries and occupational hazardous, these consequences have a medico legal significance. Problem arising in this case is to display that the patient left with permanently afflicted fertility had a good fertility prior to injury.
© 2009 European Association of Urology. Published by Elsevier Inc. All rights reserved.