Jozef Marenčák, Rudolf Moro, Dymitry Lapatko, Michaela Trabalíková
Objective: Retrospective evaluation of diagnosis and treatment of external genital injuries.
Material and methods: Between 1 Jan 1985 to 31 Dec 2014 on the Urology department FNsP Skalica a total of 42 patients
(39 men and 3 women, average age 27.5 /range 8 – 64 years) were treated for external genital injury. Injury of
the penis were noted in 17/ 39 (44 %), scrotum injury in 19/ 39 (49 %) and mixed trauma of the penis + scrotum in 3/ 39
(7 %) of males. Blunt trauma was recorded in 29/ 42 (69 %) – two of these 29 (7 %) were burns. Penetrating injury was
noted in 13/ 42 (31 %) of patients – in this group was recorded self – inflicted mechanism of injury in 6/ 13 (46 %) of men.
Diagnostic procedures utilized by patients with genital trauma: history, physical and laboratory examinations, some
imaging tests, gynaecological and endoscopic investigation and other.
Results: Scrotal ultrasonography (USG) confirmed the rupture of the testis in 7/ 8 (87.5 %) of patients with testicular
damage confirmed in a surgical revision. Surgical methods of treatment were used in 80 % of patients with injury of
the penis and in 77.3 % of men with trauma of the scrotum. Satisfactory erection was noted in 4/5 (80 %) of patients
12 month after surgery for penis fracture and weaker erection was observed in one patient after conservative therapy
of this accident. The average time from injury to the start of the treatment was: 38.5 (range 0.5 – 112) hours in patients
with injury of the penis and 8.5 (0.5 – 56.0) hours in men with scrotal trauma.
Conclusions: Trauma of the external genitalia does not occur often, tends to have a varied clinical picture depending on
the mechanism of injury. Most genital injuries (in males and females) were caused by blunt trauma. Diagnosis of external
genital injuries was always adjusted to an individual patient. Precise scrotum USG proved to be sufficiently accurate
in determining the rupture of the testis. The timing of solutions for genital injuries was determined mainly by: the risk
of infection (according to the aetiology of trauma), the possibility of erectile function loss and fertility in males or risk
of more massive bleeding in women. Early surgical management, with closure of tunica albuginea was long cosmetically
and functionally effective in patients with penile fracture. Early surgical exploration was also effective in all cases
(even if only suspected) of testicular rupture.