Injuries to the male external genitalia in the material of the Department of Urology of the Military Institute of Medicine – National Research Institute, using the AAST trauma scale

Introduction and objective: Injuries to male external genitalia account for 2% of all injuries. Most affected patients require surgical intervention. This study aimed to retrospectively analyse the diagnosis and treatment of male external genital injuries using the American Association for the Surgery of Trauma (AAST) scale to assess their severity. Materials and methods: A total of 998 men with abdominal and pelvic injuries were admitted to the Emergency Department of the Military Institute of Medicine – National Research Institute in Warsaw, Poland, between October 2017 and August 2022. Injuries to male external genital organs were identified in 26 patients (3%). The mean age of this group was 37 years (21 to 72 years). Direct trauma to external genital organs was diagnosed in 14 patients (54%). In 12 patients (46%), external genital trauma was an accompanying injury to multi-organ injuries resulting from traffic accidents or falls from heights. All patients underwent a detailed history taking and physical examination, as well as ultrasound and/or trauma scan, followed by AAST. Results: In the group of 26 patients with external genital trauma, 14 patients (54%) were classified for urgent surgical treatment, including 8 patients (31%) with penile fractures and 6 patients (23%) with scrotal and testicular injuries. In one case, penile fracture was accompanied by urethral damage. In another case, orchidectomy was necessary in the group of patients with scrotal injuries. Among the 12 patients (46%) with multi-organ injuries following traffic accidents or falls from heights, bed regimen and antibiotic therapy allowed full recovery. According to the AAST scale for penile, scrotal, and testicular injuries, grade I was observed in 14 patients, grade II in 6 patients, grade III in 5 patients, grade IV in 3 patients, and grade V in 1 patient. Conclusions: The AAST scale is an effective and practical tool for assessing injuries to the male external genitalia. Early diagnosis and surgical treatment of male genital injuries reduce the risk of complications, whereas delayed diagnosis and treatment may result in infection and reproductive dysfunction.