Testicular fracture - recognition and treatment

The testicular fracture is a complaint, which is evident in the male genital area, but its causes are usually outside the genital region. Often sufferers notice the testicular fracture only in the advanced stage and threaten permanent consequences - up to an irreversible inability to procreate.

contents

• The testicular fracture is not a rupture of the testicle
• causes
• testicular torsion
• cancer
• symptoms
• diagnosis
• treatment
• What must patients pay attention to?
• late effects

The male sexual organ is extremely complex. It consists of the testes, the testicular artery, the head and tail end, the epididymis, the epididymal margin, the free testicular margin, the scrotum and the spermatic cord. However, the male genitalia are not only complex but also extremely sensitive. Pressure can lead to both direct scrotal damage and damage to the tissues around the testicles.

A testicular fracture does not necessarily have to be accompanied by pain. Partly appear only fatigue and a general malaise. (Image: Syda Productions / fotolia.com)

The testicular fracture is not a rupture of the testicle

In the embryo, the testicles migrate through the inguinal canal into the scrotum. Testicular fracture is, strictly speaking, a wrong term. It does not break a testicle, and it does not break both testicles, but it breaks or tears the tissue in the abdominal wall. Above the groin are the intestines, and above the testicles is a "break bag" of peritoneum. This can sink into the scrotum as the weight of the intestines gets out of hand. This sinking of the intestines into the scrotum is what we call testicular rupture.

Every 20th man experiences such a testicular fracture in his life. Particularly at risk are small boys and men between the 40th and 50th year of life.

causes

A testicular fracture is not necessarily associated with a hernia, however, created by a broken groin a gap in the abdominal wall through which parts of the intestine can sink into the scrotum. Groin hernias in adults are often caused by jerky lifting of heavy weights, because the pressure on the abdominal wall is then so great that the tissue ruptures.

Even a malformation of the diaphragm can lead to altered pressure conditions in the abdomen and as a result to a scrotal hernia / a testicular rupture. The cause is usually a congenital damage of the diaphragm through which organs shift.

testicular torsion

On the testicle or epididymis but can also twist the stem. Then it is a testicular torsion. Affected are usually infants, because their testicle envelope is not completely grown together. Adults suffer such a twist, especially as a result of abrupt movements. In severe cases, such torsion can lead to a testicular fracture.

A testicular torsion and other causes can trigger the testicular fracture, but in most cases this is due to a hernia. (Image: joshya / fotolia.com)

cancer

Testicular cancer, metastases in the abdominal tissue or in the inguinal canal can damage the tissue there so that a gap is created. Also here intestinal parts can sink into the scrotum.

symptoms

Possible symptoms of a testicular fracture are:

• An enlargement of the testicle
• Tension in the inguinal tissue
• General feelings of illness
• Blood in the stool
• fatigue
• Lack of physical performance
• Pain in testicles and abdomen
• Indigestion, diarrhea or constipation

diagnosis

If you suspect testicular fracture you should consult a doctor immediately. He uses methods such as magnetic resonance imaging, X-ray or sometimes even a laparoscopy. So he recognizes the positions of fracture sack, peritoneum and intestines.

treatment

A testicular fracture must be treated surgically in any case, only so the physician can bring the affected organs back to their original position. First of all, the doctor applies a fracture tape. This prevents the break bag from sinking further down. At the same time, it pushes the peritoneum through the hernia gate back into the inguinal region. A broken band is a belt with a solid plate.

If it is possible to guide the hernia sac and the intestines to their healthy position, it is important to close the hernia gate. Surgeons use a special suture technique developed by Edorado Bassini. Today, however, it is also possible to close the gap in the tissue through a plastic net. This is done either in front of the peritoneum in the context of an abdominal cavity mirroring with metal clips or on the peritoneum in order to strengthen the abdominal wall as a whole.

What must patients pay attention to?

If you heal your testicular hernia, you should avoid any strong pressure and abrupt movement until the abdominal wall is intact again - about four months. If you strain the inguinal canal and testes in the healing phase, this can lead to another testicular rupture.
So do not wear heavy, do not help friends with parades where you carry full boxes through stairwells, and reduce sports that strain your abdomen or make alternate movements. In particular:

• No ski!
• No skateboard, inline skating or cross bike!
• No climbing!
• When weight training you renounce all exercises that burden the abdomen, pure biceps, triceps or shoulder training is not a problem, pelvic exercises, trunk bends, etc. should under no circumstances perform.
• Stretching and bar gymnastics, ups and downs as well as floor gymnastics please refrain.

late effects

Occasionally, blood vessels and nerves become trapped in testicular fractures. As a result, the intestine is often perfused poorly and very rarely organs even die. If testicular artery or spermatic cord are disconnected, this can even lead to permanent impotence. (Dr. Utz Anhalt)
Specialist supervision: Barbara Schindewolf-Lensch (doctor)