林于巧、高耀臨

國立成功大學附設醫院 泌尿部

Yu-Chiao Lin, Kao-Yao Lin

Department of Urology, National Cheng Kung University Hospital, Tainan, Taiwan

 

Dislocation of testis and degloving injury of penile skin are both uncommon in trauma cases. These two conditions sometimes need surgical treatment. Here we introduce a case of with combined dislocation of testis and degloving injury of penile skin after motorcycle accident.This case was a 30-year-old man without underlying disease. He suffered from traffic accident while he was riding motorcycle. He was crashed by a car and his genital area hit the fuel tank of his motor cycle. He complained of urinary difficult and bleeding from his penis. Physical examination found dislocated left testis in left inguinal area, and bleeding from the opening of his prepuce. However his prepuce was too swelling and urethral meatus was unable to be exposed. Urethral injury was suspected but urethragram was unable to be performed. Bedside ultrasound was performed and found distended bladder, right intratesticular hematoma and left testis in inguinal area. Color duplex ultrasound confirmed bilateral testis with blood flow. Further abdominal and pelvis computed tomography showed dislocation of left testis in left inguinal area and right intratesticular hematoma. No other associated major injury was found. Then he received scrotum exploration surgery. Reduction of dislocated left testis and bilateral orcheopexy were done. In order to expose urethral meatus, dorsal slit of prepuce was done. Then extensive laceration with degloving injury of penile skin was found and then primary repair was done. Urethragram was performed and fortunately there was no obvious urethra injury. He recovered smoothly after surgery. His wound healed well, and no scrotal pain was noted during postoperative follow-up.