Traumatic testicular dislocation is a rare complication of high-energy blunt trauma, most commonly occurring in motorcycle collisions. When associated with pelvic ring injuries, diagnosis may be delayed due to haemodynamic instability, soft-tissue swelling and distracting injuries. We report a 20-year-old man who sustained an unstable anteroposterior compression pelvic ring injury following a motorcycle accident, complicated by bilateral extra-scrotal testicular dislocation. Initial clinical assessment was limited by extensive scrotal haematoma. Cross-sectional imaging and Doppler ultrasonography demonstrated bilateral displacement of the testes into the superficial inguinal regions with reduced perfusion. The patient underwent combined orthopaedic and urological surgical management, including definitive pelvic fixation and bilateral orchidopexy. Postoperative imaging confirmed restoration of normal testicular position and blood flow. At 12-month follow-up, normal urogenital, endocrine and sexual function were preserved. • Bilateral traumatic testicular dislocation is a rare but critical complication of high-energy blunt trauma, often associated with motorcycle accidents and unstable pelvic fractures. • Extensive scrotal hematoma and distracting injuries can mask the diagnosis; clinicians must maintain a high index of suspicion. • Early diagnosis using Doppler ultrasonography or CT is essential to prevent vascular compromise and long-term sequelae like infertility or hypogonadism. • Multidisciplinary management between orthopedic and urologic teams ensures both pelvic stability and urogenital functional preservation.
Giannoudis et al. (Fri,) studied this question.