ISSN 2398-2977      

Testis: hematoma

pequis

Introduction

  • A hematoma of the testis is defined as an extravasation of blood into testicular parenchyma or on the testicular surface.
  • Cause: usually trauma, penetrating wound or biopsy.
  • Signs: swollen painful testis.
  • Diagnosis: palpation, ultrasonography.
  • Treatment: anti-inflammatory drugs, cold hydrotherapy, rest, surgical castration.
  • Prognosis: untreated cases develop irreversible degeneration of the testicle due to thermal damage.

Pathogenesis

Etiology

Either Caused by blunt trauma or penetrating wound.
Or As a sequel to locally invasive testicular tumors Testis: neoplasia - seminoma Teratoma.
Or By testicular biopsy.
 

Pathophysiology

  • Caused by extravasation of blood into testicular parenchyma or on the surface of the testicle.
  • 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 normal local thermoregulatory mechanisms and causing further damage.
  • 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.
  • There is a risk that the contralateral testis may be damaged by elevated temperature in the scrotum.

Diagnosis

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Treatment

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Outcomes

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Further Reading

Publications

Refereed papers

Other sources of information

  • Turner R M O (2007) Testicular Abnormalities. In: Current Therapy in Equine Reproduction. Eds: Samper J C, Pycock J F & McKinnon A O. Saunders Elsevier, USA. pp 195-204.

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