Equis ISSN 2398-2977

Testis: hematoma

Contributor(s): Terry Blanchard, Graham Munroe, Elaine Watson

Introduction

  • A hematoma of the testis is defined as an extravasation of blood into testicular parenchyma.
  • Cause: usually trauma.
  • Signs: swollen painful testis.
  • Diagnosis: palpation, ultrasonography.
  • Treatment: surgical castration.
  • Prognosis: untreated cases develop irreversible degeneration of the testicle.

Pathogenesis

Etiology


EitherCaused by blunt trauma.
OrAs a sequel to locally invasive testicular tumors   Testis: neoplasia - seminoma    Teratoma  .
OrTesticular biopsies.

Pathophysiology

  • Caused by extravasation of blood into testicular parenchyma.
  • Integrity of the testicular capsule (tunica albuginea) is usually maintained.
  • Testicular tissue is very vascular, and considerable hemorrhage can result from rupture of testicular vessels. Extensive testicular parenchymal necrosis ensues.
  • Complete loss of testicular function may occur with the testicle becoming small and atrophic.
  • Testicular injuries could permit exposure of spermatozoa to the systemic circulation and result in anti-sperm antibody production.
    Anti-sperm antibodies can cause subfertility or sterility

Timecourse

  • If hemorrhage is contained within the tunica albuginea, development of adhesions between the surrounding tunics and scrotum may occur, thus preventing the local thermoregulatory mechanisms.
  • With swelling, edema or inflammation of the testes, abnormal spermatozoa will be produced until normal heat exchange can be restored.
  • If left untreated, the affected testis probably undergoes irreversible degeneration and atrophy.
  • Given time, the contralateral testis may undergo some compensatory hypertrophy.

Diagnosis

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Treatment

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Outcomes

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Further Reading


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