Traumatic dislocation of testis into penile shaft: a rare consequence of blunt scrotal injury

Auhtor: SI Hossain, ST Begum

Abstract:

Background: A 34 years old Muslim fisherman reported to surgical outpatient with a history of absent left testicle for 4 months and swelling of the shaft of the penis for same duration. He noticed the swelling after few days of blunt trauma over scrotum and perineal area during working. Swelling was initially painful but pain subsides within 7 days. Patient also complains of difficulty in sexual intercourse which was normal before. He was treated initially by local doctor but painless swelling continued with no further enlargement of swelling. On examination there was lump in shaft of the penis which is superficial. Swelling was globular in shape, rounded, slightly mobile and non-reducible. Swelling is non translucent and non-pulsatile. Scrotal examination reveals absent left testis. On auscultation bruit is absent. Initially lump is diagnosed as Testicular herniation in penile shaft. Differential diagnosis were Lipoma of the Penis and Arterio-venous malformation of penile vessels. Ultrasound examination of the swelling reveals testis like structure in penile shaft. After final diagnosis operative repositioning of the testis decided. Under Spinal Anesthesia with scrotal incision extending to penile shaft testis is identified above the Bucks fascia of the shaft of the penis. (Left side). Then testis is carefully dissected out. Scarring noted around the testis. Testis then repositioned in scrotum and Orchidopexy done. Skin closed primarily. Postoperative recovery was uneventful. After 30 days post operatively patient get backs to his normal sexual life.

Details

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