Diseases

Testicular fracture - detection and treatment

Testicular fracture - detection and treatment


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The testicular fracture is a symptom that can be seen in the male genital area, but the causes are mostly outside the genital region. Often, those affected only notice the testicular fracture at an advanced stage and there are permanent consequences - including irreversible disability.

The male reproductive system is extremely complex. It consists of the testicle, the testicular artery, the head and tail end, the epididymis, the epididymis margin, the free testicle margin, the testicular mesentery and the spermatic cord. The male genitals are not only complex, but also extremely sensitive. Pressure can lead to direct injuries to the testicles as well as damage to the tissue around the testicles.

The testicular fracture is not a testicular fracture

In the embryo, the testicles migrate through the inguinal canal into the scrotum. Testicular fracture is actually a wrong term. This is because one testicle does not break, and neither testicle breaks, but it breaks or tears the tissue in the abdominal wall. The intestines lie above the groin, and a “hernial sac” made of peritoneum lies above the testicles. This can sink down into the scrotum if the weight of the intestines takes over. This sinking of the intestines into the scrotum is what we call the testicular fracture.

Every 20th man experiences such a testicular fracture in his life. Young boys and men between the ages of 40 and 50 are particularly at risk.

Causes

A testicular fracture is not necessarily accompanied by a hernia, but a broken groin creates a gap in the abdominal wall through which parts of the intestine can sink down into the scrotum. Inguinal hernias in adults often result from jerky lifting of heavy weights, because the pressure on the abdominal wall then becomes so great that the tissue tears.

A malformation of the diaphragm can also lead to changes in the pressure in the abdominal cavity and, as a result, to a scrotal hernia / testicular fracture, which is usually due to congenital damage to the diaphragm through which organs are displaced.

Testicular torsion

The stem can also twist on the testicles or epididymis. Then it is a testicular torsion. Infants are mostly affected because their testicular sheath is not yet completely overgrown. Adults experience such torsion particularly as a result of abrupt movements. In severe cases, such torsion can lead to a testicular fracture.

Cancer

Testicular cancer, metastases in the abdominal tissue or in the inguinal canal can damage the tissue there so that a fracture gap is created. Here, too, parts of the intestine can sink into the scrotum.

Symptoms

Possible symptoms of a testicular fracture are:

  • An enlarged testicle
  • Tension in the groin tissue
  • General feelings of illness
  • Blood in the stool
  • Exhaustion
  • Lack of physical performance
  • Pain in the testicles and abdomen
  • Indigestion, diarrhea or constipation

Diagnosis

If you suspect a testicular fracture, you should immediately consult a doctor. He uses methods such as magnetic resonance imaging, X-rays or sometimes even a mirror examination for the examination. This is how he recognizes the positions of the hernial sac, peritoneum and intestines.

Treatment

A testicular fracture must always be treated surgically, as this is the only way for the doctor to bring the affected organs back into their original position. First of all, the doctor puts on a truss. This prevents the hernial sac from sinking further down. At the same time, it pushes the peritoneum back through the hernia into the groin region. A truss is a belt with a fixed plate.

If the hernial sac and the intestines can be moved into their healthy position, the goal is to close the hernial portal. For this, surgeons use a special suturing technique that Edorado Bassini developed. Today, however, it is also possible to close the gap in the tissue with a plastic mesh. This happens either in front of the peritoneum as part of an abdominal cavity mirroring with metal clips or on the peritoneum to strengthen the abdominal wall as a whole.

What should patients pay attention to?

When your testicular fracture heals, you should avoid any strong pressure or abrupt movement until the abdominal wall is intact - about four months. If you strain the inguinal canal and testicles during the healing phase, this can lead to a new testicular fracture.
So do not carry heavy, do not help friends with moves, where you carry full boxes through stairwells, and reduce sports in which your abdomen is stressed or changing movements occur. The following applies in particular:

  • No ski!
  • No skateboard, inline skating or cross bike!
  • No climbing!
  • With weight training, do without all exercises that strain the lower abdomen, pure biceps, triceps or shoulder training is unproblematic, pelvic exercises, trunk bends etc. should not be carried out under any circumstances.
  • Please refrain from stretching and parallel bars, ups and downs as well as floor exercises.

Late effects

Sometimes blood vessels and nerves get stuck in testicular fractures. As a result, the intestines are poorly supplied with blood and very rarely even organs die. If the testicular artery or spermatic cord is pinched off, this can even lead to permanent impotence. (Dr. Utz Anhalt)

Author and source information

This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.

Dr. phil. Utz Anhalt, Barbara Schindewolf-Lensch

Swell:

  • Amboss GmbH: Inguinal hernia (Hernia inguinalis) (accessed: August 7, 2019), amboss.com
  • Junge, Karsten / Oral, Hasan / Otto, Jens: Rare cause of an initial gastric stenosis - the scrotal hernia, Dtsch Arztebl Int, 2019, aerzteblatt.de
  • Dr. med. Dirk Manski: Inguinal hernias and scar hernias (accessed: 07.08.2019), urologielehrbuch.de
  • Gasser, Thomas: Basic knowledge of urology, Springer, 6th edition, 2015
  • Hammes, Christoph / Heinrich, Elmar / Lingenfelder, Tobias: Basics Urologie, Urban & Fischer Verlag / Elsevier GmbH, 4th edition, 2019
  • Mayo Clinic: Inguinal hernia (accessed: 07.08.2019), mayoclinic.org
  • Urology Care Foundation: What are Hydroceles and Inguinal Hernias? (Accessed: 07.08.2019), urologyhealth.org
  • Harvard Health Publishing: Inguinal Hernia (accessed: August 7, 2019), health.harvard.edu

ICD codes for this disease: K40ICD codes are internationally valid encodings for medical diagnoses. You can find yourself e.g. in doctor's letters or on disability certificates.


Video: Testicular Cancer: What You Really Need to Know. UCLAMDCHAT Webinars (October 2022).