Testicular Rupture Associated With an Unconventional Mechanism of Action

Testicular and scrotal trauma is most commonly divided into two classifications based on the mechanism of action, blunt and penetrating, with penetrating trauma being reported more frequently. Blunt testicular injury is often due to motor vehicle accidents or contact sports where scrotal protection is not regularly worn, such as basketball or soccer. Several hours after initially being struck in the left testicle by a fiberglass pole while vaulting, a 23-year-old man presented to the emergency department for testicular pain and swelling. Scrotal edema and ecchymosis were found on physical examination. Ultrasound findings showed a hydrocele with debris and structural changes within the testicle, suggestive of a testicular rupture. The patient was taken to the operating room for decompression of the hydrocele and further exploration. A testicular rupture was confirmed and repaired with partial resection of the seminiferous tubules. A follow-up appointment two weeks after surgery showed a well-healed incision without complication, and a semen analysis was completed at six weeks with normal results. This case exhibits a unique mechanism of action for testicular rupture due to the lack of track-and-field-related trauma reported within the literature. Rapid diagnostic and surgical treatment were vital in this case to reduce the risk of fertility concerns and orchiectomy. Emergency medical providers must have a high index of suspicion for testicular rupture, given the severe complications if such a diagnosis is missed despite unusual mechanisms of injury.