Scrotal Injury

　　1. Pathogenesis of the Disease

　　1. Closed injury

　　Including scrotal contusion, scrotal hematoma, etc. The cause of injury is kick injury, straddle injury, crush injury, etc., and it often occurs during daily exercise and heavy physical labor.

　　2. Open injury

　　Including laceration, avulsion injury, penetrating injury, and gunshot wounds, etc. They often occur in industrial and mining labor, war wounds, or animal bites, etc.

　　2. Pathogenesis

　　The scrotum and its contents are close to the body surface and are prone to injury, including physical (mechanical external force, heat, low temperature, radiation, etc.), chemical (strong acid, strong alkali, yellow phosphorus, corrosive solvents or gases, etc.), and biological (bacteria, viruses, parasites, insects, animals, etc.) injuries. However, the position of the scrotum is relatively concealed in the human body, and the scrotal tissue is soft and elastic, with a certain degree of mobility in its contents, so the chance of injury is not very large. Among the many causes of injury, mechanical external force causing tissue trauma is more common, and the injury condition is complex. Because the scrotum has a rich blood supply, there are a large number of small blood vessels between the skin and subcutaneous fibrous membrane, and the tissue inside the scrotum is loose, so after injury, the skin may become ecchymotic in mild cases, and in severe cases, due to vascular rupture, hematoma or blood cyst may form. In the early stage of injury, the blood in the hematoma is red, which gradually turns dark red, and at this time, there may be fluctuation. The blood gradually becomes thick, and the fluctuation disappears, forming a hard mass. Due to the compression of the hard mass on the spermatic cord or testicular blood supply, atrophy of the testicle may occur.

　　Scrotal injury is usually caused by direct trauma to the scrotal tissue, resulting in the destruction of the integrity of the scrotum. The testicle inside can be injured, and severe testicular injury can cause sperm production disorders and lead to infertility. Since this disease belongs to traumatic disease, it often causes complications such as wound suppuration and infection in clinical practice, and severe infection can enter the blood circulation to cause sepsis.

　　The main symptoms of scrotal injury are bleeding and pain. If the testicle is not injured, there is usually no shock. The types of injury are divided into closed injury and open injury. The main clinical symptoms are bleeding and pain. The treatment method varies with the degree of injury.

　　This disease is caused by direct trauma to the testicle, such as kicks, falls, or riding injuries that directly cause injury. Therefore, attention should be paid to living habits, high-risk workers such as construction workers and miners are prone to injury, and protection should be paid during the work process. Pay attention to calmness in dealing with matters, avoid emotional excitement leading to conflict and causing this disease. In addition, early discovery, early diagnosis, and early treatment are also of great significance for the prevention of this disease.

　　1. Ultrasound
　　It can understand the condition of scrotal contents injury, especially it is meaningful for testicular epididymal injury.
　　2. X-ray
　　The retention of foreign bodies in the scrotum, such as shrapnel, glass fragments, small stones, etc., in cases of open scrotal injury, is helpful for understanding.
　　3. Diagnosis
　　The diagnosis of scrotal injury is not difficult, and the basis for diagnosis is: ① There is a history of scrotal trauma; ② The scrotum is swollen and painful, with ecchymosis on the surface skin, hematoma inside the scrotum, and in cases of open injury, the scrotal skin is stripped off and the testicle is exposed; ③ Negative light transmission test.
　　When diagnosing scrotal injury, attention should be paid to: ① Whether the scrotal injury is accompanied by other injuries, such as penile injury, testicular injury, testicular torsion, spermatic cord injury, etc.; ② The scope of scrotal hematoma; ③ Whether there are foreign bodies in the scrotum.

　　1. Eat more fresh vegetables and fruits to increase the intake of vitamin C and other components to enhance the body's immune ability.

　　2. Prefer light food, eat more vegetables and fruits, rationally match the diet, pay attention to sufficient nutrition, and avoid smoking and drinking, spicy food, greasy food, and smoking and drinking.

　　3. Strengthen physical exercise, enhance physical fitness, reduce risk factors such as smoking and excessive drinking, and improve one's immunity.

　　4. Pay attention to the protection of the scrotum in daily life to prevent injuries such as kicks and scratches during play or fighting.

　　I. Treatment

　　1. Open Scrotal Injury

　　For scrotal lacerations, thorough debridement should be performed, and primary repair should be carried out after removing necrotic tissue and foreign bodies. If there is a large defect in the scrotal skin, and the testicle cannot be fully covered, the testicle can be temporarily buried under the subcutaneous tissue of the inner thigh, and the testicle can be returned to the scrotum later through a secondary scrotal plastic surgery.

　　2. Closed Scrotal Injury

　　(1) Scrotal Contusion: The patient should rest in bed, elevate the scrotum, apply cold compresses locally first, and then apply heat compresses after 48 hours to promote the absorption of ecchymosis as soon as possible. At the same time, antibiotics are given to prevent infection.

　　(2) Scrotal Hematoma: Small hematomas are treated with scrotal support, local compression, and cold compresses. If the hematoma is large and gradually worsens, surgical treatment is required. During the operation, clot lumps are cleared, and bleeding is stopped completely. Antibiotics are used for anti-infection treatment. If infection is complicated and forms an abscess, incision and drainage should be performed.

　　(3) Hydrocele: Hydrocele is bleeding within the tunica vaginalis. In the early stage, it is treated as a hydrocele. If there is chronic inflammation, the tunica vaginalis thickens and hardens, then a tunica vaginalis resection can be performed.

　　(4) Hematoma Organization: After a period of time, the hematoma is organized, and its shape and hardness are similar to a tumor. The organized mass compresses the testicle, leading to atrophy of the testicular tissue. Treatment should be surgical resection.

　　II. Prognosis

　　Currently, there is no relevant information