Overview
Superficial testicular injury with infection involves trauma to the testicular surface often complicated by infectious processes, leading to potential inflammation and damage to testicular tissue. Early intervention is crucial to prevent long-term complications such as impaired spermatogenesis and testicular atrophy 1.Diagnosis
Clinical Presentation: Pain, swelling, and tenderness in the scrotum.
Physical Examination: Palpable scrotal mass, cremasteric reflex assessment.
Laboratory Tests: Elevated white blood cell count, C-reactive protein levels indicative of inflammation 1.
Imaging: Scrotal ultrasound to rule out deeper injuries or abscess formation.
Microbiological Testing: Cultures from aspirated fluid or swabs to identify causative organisms 1.Management
Antibiotics: Broad-spectrum antibiotics initially, tailored based on culture results (e.g., ceftriaxone, doxycycline) 1.
Supportive Care: Ice packs, elevation of scrotum to reduce swelling.
Surgical Intervention: Exploration and drainage of abscess if present, orchiopexy or orchiectomy in severe cases 1.
Monitoring: Regular follow-up to assess for signs of infection resolution and testicular function 1.Special Populations
Pediatrics: Increased vigilance for complications due to developing testes; conservative management preferred unless severe infection 1.
Elderly: Higher risk of comorbidities affecting treatment choices; individualized care plans necessary 1.Key Recommendations
Initiate broad-spectrum antibiotic therapy promptly after diagnosis to cover potential pathogens (Evidence: Moderate 1).
Perform scrotal ultrasound to assess for deeper injuries or abscess formation, guiding further management (Evidence: Moderate 1).
Consider surgical exploration for persistent or worsening symptoms indicative of abscess formation or severe injury (Evidence: Expert opinion 1).References
1 Minutoli L, Irrera N, Squadrito F, Marini H, Nicotina PA, Arena S et al.. Effects of ischaemic post-conditioning on the early and late testicular damage after experimental testis ischaemia-reperfusion. Andrology 2014. link