Skip to main content

Advertisement

Traumatisme de la verge et des organes génitaux

Testicular and penile injuries

Article metrics

  • 1672 Accesses

  • 1 Citations

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.

References

  1. 1.

    AL SALEH B.M., ANSARI E.R., AL ALI I.H. et al.: Fractures of the penis seen in Abu Dhabi. J. Urol., 1985, 134: 274–275.

  2. 2.

    ASGARI M.A., HOSSEINI S.Y., SAFARINEJAD M.R. et al: Penile fractures: evaluation, therapeutic approaches and long-term results. J. Urol., 1996, 155: 148–149.

  3. 3.

    BENCHEKROUN A., IKEN A., KASMAOUI E. et al.: Traumatisme des bourses. A propos de 40 cas. Ann. Urol., 2001, 35: 349–352.

  4. 4.

    BERGNER D.M., WILCOX M.E., FRENTZ G.D.: Fracture of penis. Urology, 1982, 20: 278–280.

  5. 5.

    BUCKLEY J.C., McANINCH J.W.: Use of ultrasonography for the diagnosis of testicular injuries in blunt scrotal trauma. J. Urol., 2006, 175: 175–178.

  6. 6.

    CASS A.S., LUXENBERG M.: Testicular injuries. Urology, 1991, 37: 528–553.

  7. 7.

    CASS J.: Immediate radiological evaluation and early surgical management of genito-urinary lesions from external trauma. J. Urol., 1979, 122: 722–724.

  8. 8.

    CENDRON M., WHITMORE K.E., CARPINIELLO V. et al.: Traumatic rupture of the corpus cavernosum: evaluation and management. J. Urol., 1990, 144: 987–991.

  9. 9.

    CROSS J.J.L., BERMAN L.H., ELLIOTT P.G. et al.: Scrotal trauma: a cause of testicular atrophie. Clin. Radiol., 1999, 54: 317–320.

  10. 10.

    DE ROSE A.F., GIGLIO M., CARMIGNANI G.: Traumatic rupture of the corpora cavernosa: new physiopathologic acquisitions. Urology, 2001, 57: 319–322.

  11. 11.

    DESCOTES J.L., HUBERT J.: Apport de l’imagerie dans les traumatismes de la verge. Prog. Urol., 2003, 13: 1157–1160.

  12. 12.

    DINCEL C., CASKURLU T., RESIM S. et al.: Fracture of the penis. Int. Urol. Nephrol., 1998, 30: 761–765.

  13. 13.

    EKE N.: Fracture of the penis. Br. J. Surg., 2002, 89: 555–565.

  14. 14.

    ELABD S., ABU FARHA O., EL GHARBAWI M. et al.: Fracture of the penis and the result of surgical management. Injury, 1988, 19: 381–383.

  15. 15.

    EL SHERIF A.E., DAULEH M., ALLOWNEH N. et al.: Management of fracture of the penis in Qatar. Br. J. Urol., 1991, 68: 622–625.

  16. 16.

    FERGANY A.F., ANGERMEIER K.W., MONTAGUE D.K.: Review of Cleveland Clinic experience with penile fracture. Urology, 1999, 54: 352–355.

  17. 17.

    FERREIRA V., RIVERO M.A., SHIRREN C. et al.: Male fertility after unilateral orchiectomy comparative study. J. Urol., 1989, 141: 441A.

  18. 18.

    GOMES C.M., RIBEIRO-FILHO L., GIRON A.M. et al.: Genital trauma due to animal bites. J. Urol., 2000, 165: 80–83.

  19. 19.

    GROSS M.: Rupture of the testicle, the importance of early surgical treatment. J. Urol., 1969, 101: 196–197.

  20. 20.

    HINEV A.: Fracture of the penis: treatment and complications. Acta Med. Okayama, 2000, 54: 211–216.

  21. 21.

    KARADENIZ T., TOPSAKAL M., ARIMAN A. et al.: Penile fracture: differential diagnosis, management and outcome. Br. J. Urol., 1996, 77: 279–281.

  22. 22.

    KATTAN S., YOUSSEF A., ONUARA V., PATIL M.: Recurrent ipsilateral fracture of the penis. Injury, 1993, 24: 685–686.

  23. 23.

    MANSI M.K., EMRAN M., EL MAHROUKY A. et al.: Experience with penile fractures in Egypt: long-term results of immediate surgical repair. J. Trauma., 1993, 35: 67–70.

  24. 24.

    MBONU O.O., AGHAJI A.E.: Fracture of the penis in Enugu, Nigeria. J.R. Coll. Surg. Edinb., 1992, 37: 309–310.

  25. 25.

    MICALLEF M., AHMAD I., RAMESH N. et al.: Ultrasound features of blunt testicular injury. Injury, 2001, 32: 23–26.

  26. 26.

    MUNTER T.W., FALESKI E.J.: Blunt scrotal trauma, emergency department evaluation and management. Am. J. Emerg. Med., 1989, 7: 227–232.

  27. 27.

    NICOLAISEN G., MELAMUD A., WILLIAMS R.D. et al.: Rupture of the corpus cavernosum: surgical management. J. Urol., 1983, 130: 917–919.

  28. 28.

    NOURI M., KOUTANI A., TAZI K. et al.: Les fractures du pénis: à propos de 56 cas. Prog. Urol., 1998, 8: 542–547.

  29. 29.

    ORVIS B.R., MC ANINCK J.W.: Penile rupture. Urol. Clin. North Am., 1989, 16: 369–375.

  30. 30.

    PAPAREL P., N’DIAYE A., LAUMON B. et al.: The epidemiology of trauma of the genitourinary system after traffic accidents: analysis of a register of over 43 000 victims. Br. J. Urol. Int., 2006, 97: 338–341.

  31. 31.

    PHILP T., COLLIN J.: The fractured shaft — an unusual penile injury. Br. J. Surg., 1983, 70: 93.

  32. 32.

    PRUNET D., BOUCHOT O.: Les traumatismes du pénis. Prog. Urol., 1996, 6: 987–993.

  33. 33.

    RUCKLE H.C., HADLEY H.R., LUI P.D.: Fracture of penis: diagnosis and management. Urology, 1992, 40: 33–35.

  34. 34.

    SLAVIS S.A., SCHOLZ J.N., HEWITT C.W. et al.: The effects of testicular trauma on fertility in the lewis rat and comparisons to isoimmunized recipients of syngeneic sperm. J. Urol., 1990, 143: 638–641.

  35. 35.

    UYGUR M.C., GULERKAYA B., ALTUG U. et al.: 13 years’ experience of penile fracture. Scand. J. Urol. Nephrol., 1997, 31: 265–266.

  36. 36.

    WESPES E., LIBERT M., SIMON J. et al.: Fracture of the penis: conservative versus surgical treatment. Eur. Urol., 1987, 13: 166–168.

  37. 37.

    ZARGOOSHI J.: Penile fracture in Kermanshah, Iran: report of 172 cases. J. Urol., 2000, 164: 364–366.

Download references

Author information

Correspondence to Olivier Simonin.

Additional information

Présentation au XXIIème congrès de la SALF Marseille 2005

Rights and permissions

Reprints and Permissions

About this article

Cite this article

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

Download citation

Mots clés

  • traumatisme organes génitaux externes
  • traumatisme testiculaire
  • fracture pénis
  • hématome testicule
  • atrophie testiculaire
  • impuissance

Key words

  • trauma
  • external genital organs
  • testicular trauma
  • pertile fracture
  • testicular haematoma
  • testicular atrophy
  • impotence