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Caniklioglu M, Oztekin Ü, Fırat F, Ataç F, Doğanyigit Z, Oflamaz AO. Is testicular tissue resection effective in testicular compartment syndrome? Niger J Clin Pract 2023; 26:1361-1367. [PMID: 37794551 DOI: 10.4103/njcp.njcp_170_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/06/2023]
Abstract
Background There have been many testicular losses due to testicular compartment syndrome (TCS). Studies are ongoing to lower the pressure within tunica vaginalis during TCS. Aims To provide enough space for reperfusion of the testicular tissue and to reduce intratesticular pressure by resecting testicular tissue in the affected testis for treatment of TCS. Materials and Methods The study was designed as a prospective randomized animal study. A total of 24 Wistar albino adult rats were randomly divided into three groups. After torsion surgery group 1 underwent detorsion + testicular tissue resection (TTR), while only detorsion was performed in group 2. The control group did not undergo any procedures. At the postoperative 5th day all subjects were sacrificed, and their testes were evaluated in terms of histologic findings, apoptosis, and microangiogenesis. One-way ANOVA and Tukey's test were used for analysis. Results According to Johnsen scores, all the groups were statistically different from each other and the damage in group 1 was less than in group 2 (P < 0.05). Factor VIII expressions in surgical groups were significantly higher than in the control group (P < 0.05). However, the surgical groups did not show any significant difference between each other (P > 0.05). Apoptotic cell counts were higher in both surgical groups than in the control group. Also, there was significantly higher apoptotic cell count in group 2 than in group 1 (P < 0.05). Conclusions The injury secondary to TCS is lower when TTR is performed. In the cases in which tunica vaginalis graft could not be obtained or in the delayed cases, TTR may be useful.
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Affiliation(s)
- M Caniklioglu
- Departments of Urology, Yozgat Bozok University, Yozgat, Turkey
| | - Ü Oztekin
- Urology Clinic, Kayseri System Hospital, Kayseri, Turkey
| | - F Fırat
- Department of Urology, Tokat State Hospital, Tokat, Turkey
| | - F Ataç
- Department of Urology, Batman Zilan Private Hospital, Batman, Turkey
| | - Z Doğanyigit
- Histology and Embryology, Faculty of Medicine, Yozgat Bozok University, Yozgat, Turkey
| | - A Okan Oflamaz
- Histology and Embryology, Faculty of Medicine, Yozgat Bozok University, Yozgat, Turkey
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Abidoğlu S, Karagözlü Akgül A. Close Range Gun Shot Injury Bilateral Ruptured Testis Repair Using Tunica Vaginalis Flap. Indian J Surg 2022. [DOI: 10.1007/s12262-021-03043-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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3
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Chong EY, Goh DWX, Lim AHS, Goh SSN, Balasubramaniam S. A systematic review of penetrating perineal trauma in a civilian setting. Eur J Trauma Emerg Surg 2022; 48:4365-4383. [PMID: 35262749 DOI: 10.1007/s00068-022-01908-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Accepted: 01/29/2022] [Indexed: 11/28/2022]
Abstract
PURPOSE Penetrating injuries to the perineum and associated pelvic organs have largely been reported in the military. Given the rarity of presentation and unique clinical characteristics of these injuries, we set out to address the gap in the literature in civilian settings. METHODS A systematic review of studies addressing penetrating perineal trauma from January 2000 to April 2021 was performed. Outcomes of interest were the epidemiology, associated injuries, management, follow-up, and patient outcomes. RESULTS 26 studies were included in this review, reporting on a total of 2316 patients. Most injuries occurred in males (88.1%), with gunshot wounds (88.2%) representing the most common aetiology, followed by knife wounds (5.0%), impalement (3.1%), coital injuries/sexual assault (1.5%), and others (2.4%). Regarding associated injuries, anorectal (n = 1419, 69.4%), bladder (n = 351, 32.4%), penile (n = 282, 20.8%), scrotal (n = 375, 27.7%), and testicular (n = 229, 16.9%) occurred frequently. Bony injuries involved the pelvis (n = 88, 8.1%) and femoral fractures (n = 5, 0.5%), while soft-tissue injuries involved the inguinal region (n = 19, 1.6%) and buttocks (n = 14, 1.3%). Vascular injuries occurred in 79 (7.8%) patients. Regarding patient outcomes, 65 (4.8%) deaths were reported, and significant morbidity was detected with a mean injury severity score of 18.4 detected in the cohort. In terms of complications of injury, wound/infective complications (n = 135, 61.3%) and fistula formation/leakage (n = 16, 0.7%) featured prominently. CONCLUSION Penetrating perineal trauma in the civilian population poses a considerable challenge to clinicians, compounded by the potential for multisystem injury requiring involvement of different medical and surgical specialties.
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Affiliation(s)
- Elliot Yeung Chong
- Yong Loo Lin School of Medicine, National University of Singapore (NUS), Singapore city, Singapore
| | - Daniel Wen Xiang Goh
- Yong Loo Lin School of Medicine, National University of Singapore (NUS), Singapore city, Singapore
| | - Angela Hui-Shan Lim
- Yong Loo Lin School of Medicine, National University of Singapore (NUS), Singapore city, Singapore
| | - Serene Si Ning Goh
- Department of General Surgery, Tan Tock Seng Hospital, Singapore city, Singapore
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Essien F, Eagle Z, Tate J, Barber A. Testicular Rupture: The Other Nutcracker Syndrome. CLINICAL MEDICINE INSIGHTS-CASE REPORTS 2022; 15:11795476211052416. [PMID: 35173506 PMCID: PMC8842106 DOI: 10.1177/11795476211052416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 09/16/2021] [Indexed: 11/17/2022]
Abstract
Scrotal trauma is a rare incident but when it occurs it is typically among 6 to 12 years
old boys. It is most commonly unilateral secondary to compression of the scrotal contents
against the pubic bone. The majority of trauma to the scrotal region is blunt impact but
serious injuries are rare despite the vulnerable position of the testicles. The
combination of the cremasteric reflex and mobility/strength of the tunica albuginea
contribute to reducing occurrences. However, serious injury can occur when the testicle is
trapped against the pubic bone, varying from minimal extravasation to complete parenchymal
destruction. Testicular rupture is a rare injury characterized by rupture of the tunica
albuginea resulting in exposure of the seminiferous tubules. Prompt evaluation of these
patients is crucial as a delay in surgical care may lead to loss of the injured testicle.
We present a case of acute testicular rupture in an active duty male followed by a review
of the literature.
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Affiliation(s)
- Francis Essien
- Keesler Air Force Base, Biloxi, MS, USA
- Department of Internal Medicine, Keesler Medical Center, Biloxi, MS, USA
| | - Zachary Eagle
- Keesler Air Force Base, Biloxi, MS, USA
- Department of Internal Medicine, Keesler Medical Center, Biloxi, MS, USA
| | - Joshua Tate
- Keesler Air Force Base, Biloxi, MS, USA
- Department of Internal Medicine, Division of Endocrinology, Keesler Medical Center, Biloxi, MS, USA
| | - Austin Barber
- Keesler Air Force Base, Biloxi, MS, USA
- Department of Internal Medicine, Division of Urology, Keesler Medical Center, Biloxi, MS, USA
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Ukpong AE, Akaiso OE, Udo EA, Essiet IU, Peter OBO, Etim IP. Scrotal self-inflicted gunshot injuries: report of two consecutive cases and literature review. AFRICAN JOURNAL OF UROLOGY 2021. [DOI: 10.1186/s12301-021-00234-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Isolated scrotal gunshot injuries are uncommon. Even more so when they are self-inflicted. The extent of the injury is determined by the caliber of the weapon. Established management protocols when followed yields excellent results.
Case presentations
We present two male patients, aged 41 and 51 years old, who sustained gunshot injuries to the scrotum following accidental discharges from hand guns stored in their trouser pockets. The first (41 years) sustained grade 5 American Association for Surgery of Trauma (AAST) left testicular injury and was managed by unilateral orchidectomy. The second (51 years old) sustained bilateral grade 4 AAST testicular injuries and had both testes salvaged by primary repair after meticulous debridement.
Conclusion
Isolated scrotal gunshot injuries can occur when low velocity guns are placed adjacent to the genitalia and accidentally discharged. The testes are endangered and can be devitalized requiring orchidectomy or salvaged by meticulous debridement and primary repair when viability is not compromised.
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Yokokawa S, Tabei T, Kobayashi K. Testicular rupture successfully treated with a tunica vaginalis flap. IJU Case Rep 2021; 4:82-85. [PMID: 33718811 PMCID: PMC7924093 DOI: 10.1002/iju5.12246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 11/24/2020] [Accepted: 11/28/2020] [Indexed: 11/07/2022] Open
Abstract
INTRODUCTION Testicular injury with a tunica albuginea tear is typically reconstructed by primary closure. We herein describe the successful use of a tunica vaginalis flap for reconstruction of a ruptured testis for which primary closure was not possible. CASE PRESENTATION A 21-year-old man visited our hospital with scrotal swelling after a baseball struck his left testis. Magnetic resonance imaging and ultrasonography indicated a left tunica albuginea tear, and emergency surgery was performed. Primary closure of the tunica albuginea was impossible since a tight closure could cause secondary damage. A vascular pedicle flap was prepared by shaping the tunica vaginalis to replace the tunica albuginea. He was discharged 2 days postoperatively. Ultrasonography showed normal size and blood flow in the ruptured testis at the 2-week and 3-month follow-up. CONCLUSION A testicular vaginalis flap should be considered when primary closure is difficult in cases of testicular rupture with tunica albuginea damage.
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Affiliation(s)
- Shuhei Yokokawa
- Department of UrologyYokosuka Kyosai HospitalYokosukaKanagawaJapan
| | - Tadashi Tabei
- Department of UrologyYokosuka Kyosai HospitalYokosukaKanagawaJapan
| | - Kazuki Kobayashi
- Department of UrologyYokosuka Kyosai HospitalYokosukaKanagawaJapan
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Ahmed F, Naji M, Al-Hitari A, Amer Q, Al-Sagheer M, Chowdhury U. Use of tunica vaginalis graft for repair of traumatic bilateral testicular rupture after gunshot: a case report. Pan Afr Med J 2020; 36:268. [PMID: 33088397 PMCID: PMC7545980 DOI: 10.11604/pamj.2020.36.268.21988] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Accepted: 08/06/2020] [Indexed: 11/11/2022] Open
Abstract
Bilateral testicular injuries are rare. However, the incidence of these injuries has been increasing in wartime. We describe the case of gunshot wound of the both testicle caused by high velocity bullets. The patient was managed by surgical exploration, debridement and repaired of both testis using tunica vaginalis. During the follow up, the left testis was not viable and there was a need for orchiectomy; in a follow-up of 4 months, ultrasonography showed a viable right testis with minimal atrophic change and the patient reported to have normal erection with borderline hormonal function. We describe this case of bilateral testicular rupture, which was repaired using tunica vaginalis as graft, with attention to the management and outcome of this injury process.
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Affiliation(s)
- Faisal Ahmed
- Urology Research Center, Al-Thora Hospital, Department of Urology, Ibb University of Medical Since, Ibb, Yemen
| | - Mohammed Naji
- Department of Urology, Dar Alshefa Hospital, Ibb, Yemen
| | | | - Qais Amer
- Department of Urology, Dar Alshefa Hospital, Ibb, Yemen
| | | | - Umayir Chowdhury
- School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
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8
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Male genital trauma at a level 1 trauma center. World J Urol 2020; 38:3283-3289. [DOI: 10.1007/s00345-020-03115-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Accepted: 02/02/2020] [Indexed: 11/25/2022] Open
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9
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Chiancone F, Fabiano M, Langella N, Sannino S, Fedelini P. Direct gunshot wound to the testicular artery: A rare case report. IBNOSINA JOURNAL OF MEDICINE AND BIOMEDICAL SCIENCES 2020. [DOI: 10.4103/ijmbs.ijmbs_90_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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10
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Uçar M, Akkoç A. Nadir Bir Olgu; Testiküler Rüptür. ACTA MEDICA ALANYA 2017. [DOI: 10.30565/medalanya.338763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Abstract
Management of testicular rupture with a large tunical defect may not be feasible without excision of viable tissue. This study describes the use of a vascularized tunica vaginalis flap, without debridement of viable tissue, in four adolescents. Postoperative ultrasound showed good blood flow and 80% volume of the contralateral testis in two cases. Postoperative exam revealed normal exam and ultrasonographic appearance in three patients, the fourth was demonstrated to be small and undescended during evaluation of contralateral testicular torsion. This approach is recommended in cases of large tunical defects, as it avoids the debridement of viable testicular tissue.
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12
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Clinical characteristics and surgical outcomes of penetrating external genital injuries. J Trauma Acute Care Surg 2013; 74:839-44. [PMID: 23425745 DOI: 10.1097/ta.0b013e31827e1b8a] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
BACKGROUND Penetrating external genital injuries, although uncommon, may present complex problems for the urologic and trauma surgeon. A paucity of data exists on the incidence, clinical characteristics, and management outcomes of these injuries because few institutions have the volume to report their experience. METHODS Penetrating external genital trauma presenting from 2004 to 2011 was retrospectively reviewed. Patient characteristics, operative and nonoperative management, and outcomes were analyzed while validating current guidelines. Surgical management is described in detail, and overall incidence and trends were calculated. RESULTS A total of 28,459 trauma patients were reviewed, of which 8,076 sustained penetrating injuries and 162 sustained penetrating external genital trauma. Penetrating external genital trauma was 0.57% of all trauma and 2.0% among penetrating trauma. Gunshot wounds accounted for the most common mechanism of injury (93%). Injury to the scrotum occurred in 78% and of these injuries, 63% resulted in a testicular injury, with bilateral testicular injuries occurring in 8%. Testicular reconstruction was performed in 65%. Penile injuries occurred in 28%, and urethral injuries occurred in 13%. For penile injuries, 62% were explored immediately. Urethral injuries were managed by immediate primary urethral repair (43%) or urinary diversion with delayed reconstruction (57%). In total, nonoperative management was performed in 26% of scrotal and 38% of penile injuries. The incidence of penetrating external genital injuries has remained constant during our study period, averaging 20.2 cases per year (R(2) = 0.99). The testicular salvage rate varied from 55% to 75% per year (R(2) = 0.06). CONCLUSION Penetrating external genital injuries occur at an incidence of 0.57% where scrotal injury from gunshot wounds is the most common form. Testicular preservation is possible in the majority of testicular injuries. Penile injuries were less likely to require surgical exploration compared with scrotal injuries likely because physical examination is better at confirming only superficial injury. Select patients with superficial scrotal or penile injuries may undergo nonoperative management with minimal morbidity. LEVEL OF EVIDENCE Therapeutic study, level IV; epidemiologic study, level IV.
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13
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Abstract
This article reviews recent publications evaluating the current epidemiology of urologic trauma. The authors briefly explain databases that have been recently used to study this patient population and then discuss each genitourinary organ individually, utilizing the most relevant and up-to-date information published for each one. The conclusion of the article briefly discusses possible future research and development areas pertaining to the topic.
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Affiliation(s)
- James B McGeady
- Department of Urology, University of California, San Francisco, CA 94143, USA
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14
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Quintaes IPP, Tatsuo ES, Paulo DNS, Musso C, Boasquevisque PCR. Decompressive fasciotomy in testicular torsion of the spermatic cord in rats. Acta Cir Bras 2013; 28:423-9. [DOI: 10.1590/s0102-86502013000600004] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2013] [Accepted: 05/13/2013] [Indexed: 11/21/2022] Open
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15
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Jian PY, Nelson ED, Roth DR. Use of a vascularized tunica vaginalis flap for repair of testicular rupture in a pediatric patient. Urology 2012; 79:1363-4. [PMID: 22497981 DOI: 10.1016/j.urology.2011.11.037] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2011] [Revised: 11/15/2011] [Accepted: 11/21/2011] [Indexed: 11/29/2022]
Abstract
The management of testicular rupture in children with a large tunical defect is challenging. We describe a technique suitable when primary closure cannot be achieved. A 16-year-old boy presented with right testicular rupture. Owing to the large tunical separation and excessive edema, primary closure could not be achieved. A tunica vaginalis flap was then fashioned with a broad-based pedicle to complete closure. The patient had an uneventful recovery. At 4 months postoperatively, the testis was of normal size and position, and the ultrasound findings were normal. The vascularized tunica vaginalis flap provides an excellent alternative method for closure of pediatric testicular rupture.
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Affiliation(s)
- Peter Y Jian
- Baylor College of Medicine, Texas Children's Hospital, Houston, Texas, USA
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16
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Simhan J, Rothman J, Canter D, Reyes JM, Jaffe WI, Pontari MA, Doumanian LR, Mydlo JH. Gunshot wounds to the scrotum: a large single-institutional 20-year experience. BJU Int 2011; 109:1704-7. [PMID: 21992688 DOI: 10.1111/j.1464-410x.2011.10631.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
UNLABELLED Study Type - Therapy (case series) Level of Evidence 4 What's known on the subject? and What does the study add? Penetrating trauma to the scrotum often requires operative intervention, with testicular salvage only possible when enough testicular tissue can be re-approximated in the traumatic setting. The present report represents the largest series of gunshot wound trauma to the scrotum in the literature. Further, it validates recommendations of the European Association of Urology guidelines on urological trauma that advocate operative intervention due to minimal rates of patient morbidity and the inherent limitations of scrotal ultrasonography in discerning testicular compromise. OBJECTIVE To report our 20-year experience of gunshot wounds (GSWs) to the scrotum and outline the management of this traumatic injury. PATIENTS AND METHODS We queried our institutional database for patients presenting with GSWs to the scrotum between 1985 and 2006. All patients underwent the standard trauma evaluation upon presentation, including physical examination of the external genitalia. Management was dictated by the presence or absence of a penetrating injury to the scrotum and associated traumatic injuries. Nonoperative and operative management of traumatic injury to the scrotum were used. Testicular salvage was performed when anatomically feasible. If testicular salvage was not feasible, an orchiectomy was performed. RESULTS Scrotal exploration was performed in 91 (94%) patients while six (6%) patients were treated nonoperatively. Testicular injury was found in 44 (48%) patients undergoing exploration, six (7%) of whom had bilateral testicular injuries, which gave a total of 50 injured testicles. Of the injured testicles, 24 (48%) could not be salvaged and required orchiectomy, while 26 (52%) were debrided and repaired. The most common associated genitourinary (GU) injuries were to the corpora cavernosum (n= 20 [21%]) and urethra (n= 10 [10%]). Soft tissue injury of the extremities occurred in 54 patients (56%), representing the most common non-GU-associated injury. Postoperative complications occurred infrequently: one patient (1%) returned for abscess drainage and one (1%) for haematoma evacuation. CONCLUSIONS The present report confirms that any patient with a penetrating injury to the scrotum should undergo immediate scrotal exploration. A low clinical suspicion for performing additional studies to rule out associated urethral and/or penile injury is clinically warranted. Testicular loss occurs in ≈50% of injured testicles.
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Affiliation(s)
- Jay Simhan
- Department of Urology, Temple University Hospital, Temple University School of Medicine, Philadelphia, PA, USA
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Molokwu CN, Doull RI, Townell NH. A novel technique for repair of testicular rupture after blunt trauma. Urology 2010; 76:1002-3. [PMID: 20932424 DOI: 10.1016/j.urology.2010.06.011] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2010] [Revised: 05/27/2010] [Accepted: 06/09/2010] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To present a simple technique for the repair of a ruptured testis after blunt trauma when extruded but viable testicular tissue prevents closure of the testicular capsule during surgical exploration. Preservation of viable testicular tissue is important because the risk of impaired fertility and hormone function is minimized. METHODS A 25-year-old male sustained a ruptured right testis confirmed by ultrasound. Testicular exploration was performed and hematoma evacuated. Extruded but viable testicular tissue was identified and preserved. The free edges of parietal tunica vaginalis was used to create a "neocapsule" around the testis and extruded tissue. RESULTS There were no postoperative complications. Follow-up Doppler ultrasound scan at 3 months showed a viable testis with no atrophic changes. CONCLUSIONS This technique avoids the loss of extruded but viable testicular tissue and may reduce the risk of impaired fertility and hormone function, without compromising the goals of scrotal exploration.
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Affiliation(s)
- Chidi N Molokwu
- Department of Urology, Ninewells Hospital, Dundee, UK. chidi.molokwu@.nhs.met
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18
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Civilian Gunshot Wounds to the Genitourinary Tract: Incidence, Anatomic Distribution, Associated Injuries, and Outcomes. Urology 2010; 76:977-81; discussion 981. [DOI: 10.1016/j.urology.2010.01.092] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2009] [Revised: 01/09/2010] [Accepted: 01/27/2010] [Indexed: 11/19/2022]
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19
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Salgado CJ, Monstrey S, Hoebeke P, Lumen N, Dwyer M, Mardini S. Reconstruction of the Penis After Surgery. Urol Clin North Am 2010; 37:379-401. [DOI: 10.1016/j.ucl.2010.04.015] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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Kutikov A, Casale P, White MA, Meyer WA, Chang A, Gosalbez R, Canning DA. Testicular Compartment Syndrome: A New Approach to Conceptualizing and Managing Testicular Torsion. Urology 2008; 72:786-9. [DOI: 10.1016/j.urology.2008.03.031] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2007] [Revised: 03/14/2008] [Accepted: 03/21/2008] [Indexed: 11/29/2022]
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