27.04.2018 · 👁 13,970
Genital injuries - prevalence and causes
You can get an injury to the penis or scrotum at any age, but most often patients from 15 to 40 years old are admitted to medical institutions. In children, such injuries are rare, but, as a rule, they are more difficult to treat than in adults.
According to statistics, three quarters of cases of trauma to the male genital organs today are closed: these are bruises, dislocations, fractures and pinching of the penis, displacement and bruises of the testicles, as well as blunt trauma to the scrotum, which is usually unilateral.
Recently, experts have noted an increase in injuries to the genitourinary system, including the external genitalia. This is associated, first of all, with socio-economic factors, such as, for example, the increased prevalence of extreme and contact sports. Cycling and motor sports, as well as horse racing, are noted as particularly dangerous. Frequent and forceful impacts of the perineum against the seat (or saddle) can cause damage to the genitals. There is also a risk of playing hockey and other sports where it is possible to collide with an opponent at high speed. This is especially true when athletes neglect protective equipment.
The increase in the number of private cars on city streets also leads to an increase in cases of injury: a significant proportion of both open and closed injuries to the genitals are the result of road accidents.
In addition, a high level of urological injuries is observed during various types of social clashes and unrest, as a result of acts of civil disobedience and armed conflicts.
Symptoms and manifestations of trauma to the external genitalia in men
Traumatic lesions of the genital organs can be of a different nature and have many varieties - accordingly, depending on the type of injury, the symptoms differ. These include pain of varying severity, swelling, bleeding, bruising, hematuria (the appearance of blood in the urine) and other abnormalities in urination, not to mention open wounds. As a rule, the patient himself can recognize the presence of damage to the genital organs. However, if the injury was sustained, for example, under the influence of alcohol, and the victim did not realize the moment of its receipt, these symptoms should be a reason to consult a doctor as soon as possible.
Types of genital trauma in men
First of all, injuries to the external heart organs are divided into closed and open. The former are more common in peacetime and include contusion, dislocation, fracture and pinching of the penis, as well as damage to the scrotum resulting from blunt impact or compression, and closed testicular injuries such as displacement, rupture or bruise.
Penile bruise occurs when the injured organ was not erect at the time of injury. Usually accompanied by moderate pain and the appearance of a pronounced bruise at the site of the injury. Sometimes a hematoma may form not directly under the skin, but in deeper tissues, putting pressure on the urethra, making it difficult for the patient to urinate.
Dislocation of the penis - damage to the anchoring ligaments occurs, due to which its root is displaced: under the skin in the pubic area, scrotum or perineum. This is a much more serious injury that always requires surgery.
Infringement of the penis - if the injury occurs as a result of tightening, squeezing and bandaging of the penis, including when trying to put something on it. The problem is the disruption of blood circulation below the pinched area. Because of this, if medical assistance is not provided in time, tissue death may begin - necrosis.
A penile fracture occurs if the penis was erect at the time of injury. To understand the mechanism of this injury, you need to imagine the anatomical structure of the penis: it consists of two cavernous (cavernous) bodies, covered with an elastic membrane with a high content of collagen, and a spongy (spongy) body between them. When a fracture occurs, the membrane ruptures, and sometimes damage occurs to the cavernous bodies themselves. In some cases, the fracture may be combined with a rupture of the corpus spongiosum. Today, this injury is the cause of more than half of calls for emergency urological care. It often occurs during sexual intercourse, when the erect penis suddenly hits, for example, the partner’s pubic bone. Treatment involves the need for surgery.
Closed injuries to the scrotum occur when it is compressed or bluntly struck, the first often happens during sexual intercourse, especially during alcohol or drug intoxication, the second - as a result of a fall on the perineum or other similar reasons.
Closed damage to the testicles itself can also be observed. These are bruises, ruptures, and displacements. As a rule, they are accompanied by severe pain up to painful shock, and the development of traumatic dropsy is possible.
Open injuries to the penis include lacerations, stab wounds, gunshot wounds, as well as burns (thermal, chemical, electrical, radiation) and frostbite.
Penile wounds usually require surgery to repair damaged tissue. They are dangerous not only in themselves, but also due to the high risk of developing sepsis, which, along with bleeding, can threaten the patient’s life. Thermal injuries, depending on the severity, can be treated either surgically or conservatively.
Open injuries to the scrotum are also wounds of various origins: stab wounds, lacerations, gunshot wounds, crushed wounds, etc. Most often, surgical tissue restoration is required after them.
Cases of open damage to the testicle and its membranes are extremely rare and require prompt surgery. In addition to wounds, separation of the testicle from the spermatic cord may occur. These injuries are accompanied by severe painful shock and require proper anesthesia.
Diagnosis of genital trauma
Upon admission to a doctor, the primary diagnosis consists of examination and palpation (manual examination) of the damaged area, as well as taking an anamnesis to accurately determine the causes and nature of the injury.
Further, depending on the patient’s condition, additional examination methods can be used to clarify the diagnosis, such as ultrasound scanning, magnetic resonance imaging (MRI), cavernosography (radiographic examination of the vessels of the penis with contrast injected into the cavernous bodies), as well as urethrography and urethroscopy, aimed at clarifying the integrity of the urethra, since injuries to the genital organs are often combined with its damage.
First aid for genital trauma
First of all, in case of damage to the genital organs in men, it is necessary to stop the bleeding. Outside a medical facility, ice can be applied for this purpose. It is not recommended to apply compression bandages and splints yourself unless there is extremely extensive blood loss, since squeezing the injured area can aggravate the victim’s condition. It is also necessary to take measures to anesthetize the patient and disinfect the affected areas.
It is important to preserve the severed parts of tissue before admission to the hospital: even a completely amputated penis still has a chance of being returned to its place through surgery within the first 24 hours after the injury. If the injury was caused by an animal bite, doctors will also give the patient an anti-rabies injection as first aid.
Further, the procedure for treatment depends entirely on the nature and severity of the damage. In mild cases, there is a chance to get by with bandages and careful antiseptic treatment, but much more often injuries in the genital area still require surgical intervention.
Treatment of genital trauma
The choice of treatment tactics for an injury greatly depends on its nature and severity. Thus, in case of a bruise of the penis, it is usually possible to get by with bed rest and cold compresses - surgical intervention is only necessary in the presence of deep hematomas that lead to compression of the urethra.
A dislocation, on the contrary, clearly requires emergency surgery. Sutures are placed on the torn ligaments that normally hold the root of the penis in place, and the root itself is set and fixed.
If the penis is pinched, the first step is to remove the compressing object. Doctors often have to, for example, saw through thin rings that are deeply embedded in the tissue of the penis. Usually, after this is done, normal blood supply to the penis is restored fairly quickly. However, if the patient seeks help too late and necrosis has already begun, amputation of the dead areas may be necessary.
A penile fracture is a complex case of trauma. For a long time, conservative methods were used to treat it: patients were given drugs to suppress erection, after which bandages, cooling and the prescription of anti-inflammatory drugs were practiced. However, over time, this tactic has shown itself to be unreliable, associated with a large number of serious complications, such as, for example, severe deformation of the penis as a result of fibrosis. Today it is generally accepted that a fracture of the penis in absolutely all cases is an indication for surgery, and in the shortest possible time. The longer the period of time between injury and surgery, the higher the risk of developing complications in the future. During the operation, surgeons drain the wound in the affected area, excise hematomas and remove blood clots, suturing and repairing damage to the protein membrane and cavernous bodies.
The general principle in the treatment of open injuries is to stop bleeding, prevent the development of infection, and, if possible, reconstruct damaged and severed areas. In some cases, reconstructive plastic surgery of the genital organs is used, when missing parts of tissue are taken, for example, from the surface of the thigh. For burns, surgical excision of the affected tissue is often necessary. In the case of frostbite, on the contrary, it is often possible to manage with conservative measures. Only if necrosis has already begun is surgical removal of the dead areas necessary.
With a closed scrotal injury, doctors first need to make sure that the patient's testicles are not damaged. Ultrasound research methods are used for this.
If only the tissues of the scrotum are affected by the injury, it is sometimes possible to avoid surgery: the patient is prescribed cold compresses and anti-inflammatory drugs. However, this is only possible for small hematomas. In other cases, for example, when blood accumulates in the scrotum, surgery is performed to pump it out and ligate the bleeding vessels.
In a situation where the testicles themselves are injured, the patient is clearly indicated for surgical intervention, the tactics of which are chosen depending on the nature of the damage.
As for open injuries to the scrotum, it all depends on the type and severity of the injury. Minor puncture wounds that do not damage the testicles usually heal on their own with the use of antiseptics and regular dressings. Most other cases of injury require surgery with ligation of blood vessels and suturing of tissue. In some cases, it is also necessary to remove foreign objects, excise dead tissue, and reduce the testicles.
For questions, you can contact us by phone +(998 71) 140-03-03, +(998 71) 140-01-60 and at Chilanzar, 12th block, st. M. Shaykhzoda, no. 7.