Pd31-03 Early Ultrasound May Accurately Diagnose Testicular Injury in Cases of Penetrating Scrotal Trauma

You have accessJournal of UrologyReconstruction: External Genitalia and Urotrauma (including transgender surgery and traumatic fistula) I (PD31)1 May 2024PD31-03 EARLY ULTRASOUND MAY ACCURATELY DIAGNOSE TESTICULAR INJURY IN CASES OF PENETRATING SCROTAL TRAUMA Brendan Waldoch, Isaac Melin, Mukul Sharda, Steven Xu, Thomas Carver, and Peter Dietrich Brendan WaldochBrendan Waldoch , Isaac MelinIsaac Melin , Mukul ShardaMukul Sharda , Steven XuSteven Xu , Thomas CarverThomas Carver , and Peter DietrichPeter Dietrich View All Author Informationhttps://doi.org/10.1097/01.JU.0001009432.48553.4f.03AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Historical studies suggested that scrotal ultrasound (SUS) has limited diagnostic capability when evaluating penetrating scrotal injuries. Testicular injury rates in penetrating scrotal trauma approach 50%, and prompt surgical exploration remains the standard of care. In recent years, however, the effectiveness of SUS has been demonstrated in the diagnosis of multiple scrotal pathologies including blunt trauma. Our institution has increasingly utilized SUS in the evaluation of penetrating scrotal trauma. In this study, we sought to characterize the effectiveness of such imaging in the identification of testicular injuries. METHODS: We performed a retrospective chart review of all penetrating scrotal injuries in patients≥18 years of age presenting to a single tertiary care center from 11/2007 to 7/2023. Patients were excluded if physical exam showed no dartos penetration or if they expired within 24 hours of presentation. Charts were reviewed for demographic data, trauma mechanism and severity, use of SUS within 24 hours of presentation, treatment, and injury outcomes. Radiologist read was used to determine SUS findings. Sensitivity and specificity were calculated for SUS with regards to intraoperative identification of testicular injuries. RESULTS: The charts of 94 patients were reviewed and 84 were included in our analysis. Of these, 41 (49%) underwent immediate surgical exploration and the other 43 (51%) underwent SUS (Figure 1). SUS suggested testicular injuries in 24 patients and this was confirmed in 21 (88%) on exploration. The remaining 19 had SUS negative for testicular injury. One patient (5%) with negative SUS was found to have an injury intraoperatively. Sensitivity and specificity of SUS were found to be 96% and 86%, respectively. CONCLUSIONS: In our study SUS was found to be highly sensitive in the identification of testicular injuries following penetrating scrotal trauma. These findings suggest that SUS may be useful in triaging patients without overt testicular injury and potentially prevent unnecessary surgical exploration. Download PPT Source of Funding: N/A © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e631 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Brendan Waldoch More articles by this author Isaac Melin More articles by this author Mukul Sharda More articles by this author Steven Xu More articles by this author Thomas Carver More articles by this author Peter Dietrich More articles by this author Expand All Advertisement PDF downloadLoading ...