Male genital trauma in sports

Testicular Rupture Following Blunt Scrotal Trauma

Testicular rupture after blunt scrotal trauma is characterized by rupture of the tunica albuginea and extrusion of seminiferous tubules. This is a serious injury and appropriate evaluation and management are necessary both for symptom control, but also for preservation of the testicle. Clinical examination of the scrotum following trauma is difficult and may result in incorrect triage of patients for surgical exploration. This case study describes the assessment and management of blunt testicular trauma in an adolescent lacrosse player.

Sideline Management of Nonmusculoskeletal Injuries by the Orthopaedic Team Physician

Although recognized as the most well-trained providers to address musculoskeletal injuries, many orthopaedic surgeons do not routinely treat patients with nonmusculoskeletal issues in their clinical practice. Nonetheless, when serving as a team physician, an orthopaedic surgeon may need to initiate management of or manage many nonmusculoskeletal issues. Knowing how to accurately diagnose and initiate management of sports-related medical and surgical conditions is an important facet of being an orthopaedic team physician. Common systems that may be involved include the cerebral/neurologic, ocular, dental, respiratory/pulmonary, cardiac, abdominal, and genitourinary systems. Each of these systems has specific pathologic processes and risks related to athletic or sporting participation. Orthopaedic team physicians must have a baseline familiarity with the most common nonmusculoskeletal issues to provide comprehensive quality care to athletes and patients.

Sport, doping and male fertility

It is universally accepted that lifestyle interventions are the first step towards a good overall, reproductive and sexual health. Cessation of unhealthy habits, such as tobacco, alcohol and drug use, poor nutrition and sedentary behavior, is suggested in order to preserve/improve fertility in humans. However, the possible risks of physical exercise per se or sports on male fertility are less known. Being "fit" does not only improve the sense of well-being, but also has beneficial effects on general health: in fact physical exercise is by all means a low-cost, high-efficacy method for preventing or treating several conditions, ranging from purely physical (diabetes and obesity) to psychological (depression and anxiety), highly influencing male reproduction. If male sexual and reproductive health could be positively affected by a proper physical activity, inadequate bouts of strength - both excessive intensity and duration of exercise training - are more likely to have detrimental effects. In addition, the illicit use of prohibited drugs (i.e. doping) has reached pandemic proportions, and their actions, unfortunately very often underestimated by both amateur and professional athletes, are known to disrupt at different levels and throughout various mechanisms the male hypothalamic-pituitary-gonadal axis, resulting in hypogonadism and infertility.

Perspectives in Pediatric Pathology, Chapter 23. Testicular Pathology Secondary to Physical and Chemical Injury

Testicles can be damaged by a variety of physical and chemical agents, ranging from trauma suffered in accidents or athletic activities, to diverse drugs or radiation used in cancer treatment. The immediate and long-term effects of these damaging agents at the testicular morphologic and functional levels are quite varied and may have significant impact on the fertility of the pediatric patient once reproductive age is reached.

Use of "off the shelf" extracellular matrix graft materials for repair of testicular rupture: a novel technique

OBJECTIVE

To describe a new technique for repairing traumatic testicular ruptures using readily available graft material.

MATERIALS AND METHODS

Surgical management of testicular rupture is often associated with loss of testicular parenchyma because of tissue debridement and concerns of pressure-related ischemia. We present our experience with 3 cases using a novel technique using extracellular matrix graft materials for the reconstruction of tunica albuginea in patients with testicular rupture. We describe a case using bovine pericardium (Neovasc Inc, Richmond, British Columbia) and 2 cases using cadaveric dermis (Coloplast Inc, Minneapolis, MN) to repair complex testicular defects without debridement of extruded testicular parenchyma.

RESULTS

No postoperative complications occurred in any of the patients. Long-term follow-up at 18 months for one patient revealed good cosmetic results, with radiographic findings confirming testicular integrity and flow.

CONCLUSION

The use of graft material in the repair of testicular rupture helps prevent the loss of testicular parenchyma through a tension-free closure leading to excellent cosmetic and radiographic outcomes.