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Traumatisme de la verge et des organes génitaux

Testicular and penile injuries

Andrologie volume 16, pages 187–196 (2006)Cite this article

Résumé

Les traumatismes testiculaires sont le plus souvent des traumatismes fermés rencontrés lors d’accidents de la voie publique ou de sport. Un gros testicule douloureux dans ce contexte fait poser le diagnostic et l’échographie oriente la thérapeutique vers la chirurgie en cas de rupture de l’albuginée ou de gros hématome intra testiculaire. Deux patients sur trois seront opérés et les principales séquelles rencontrées en cas de diagnostic et traitements tardifs sont l’atrophie testiculaire, la stérilité voire l’impuissance.

Les fractures du pénis sont secondaires à un traumatisme direct sur le pénis en érection avec rupture de l’albuginée et entraînent hématome, douleur et déviation pénienne. Une plaie urétrale doit être systématiquement recherchée. Cavernographie, échographie ou IRM peuvent aider au diagnostic sans être systématiques. Le traitement de référence est chirurgical précoce et les complications possibles sont les déviations péniennes, douleurs, dysfonction érectile.

Abstract

The most frequent cause of testicular injuries is blunt trauma (following sports injuries or road accidents). Penetrating injuries are rare. Increased scrotal volume and a painful testis are the main symptoms and require scrotal ultrasonography. Scrotal ultrasonography is very sensitive and specific for testicular rupture or intratesticular haematoma. Two out of three patients with testicular injuries require surgical exploration. Secondary complications due to delayed management of trauma are testicular atrophy, sterility or impotence.

Penile fracture (rupture of corpus cavernosum) is due to direct trauma by an excessive force applied to an erect penis. Swelling, penile ecchymosis, penile curvature and pain are the usual symptoms of rupture of the tunica albuginea. Urethral injury must be ruled out. Cavernosography, ultrasonography or MRI are not considered mandatory to establish a diagnosis but can be prescribed in the absence of typical signs or symptoms. Early surgical exploration and repair ensure a better outcome. Secondary complications are penile curvature, chronic pain and impotence.

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Authors and Affiliations

  1. Hôpital Salvator, 249 Bd Ste Marguerite, 13009, Marseille

    Olivier Simonin, Aurélien Carcenac, Thomas Delapparent, Gilles Karsenty & Gérard Serment

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  1. Olivier Simonin
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  2. Aurélien Carcenac
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Correspondence to Olivier Simonin.

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Présentation au XXIIème congrès de la SALF Marseille 2005

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Simonin, O., Carcenac, A., Delapparent, T. et al. Traumatisme de la verge et des organes génitaux. Androl. 16, 187–196 (2006). https://doi.org/10.1007/BF03034858

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Basic and Clinical Andrology

ISSN: 2051-4190