创伤性睾丸脱位的诊断与治疗(附5例报道并文献复习)

The diagnosis and treatment of traumatic testis dislocation (Report of five cases and review of the literature)

目的探讨创伤性睾丸脱位的诊断与治疗。方法回顾分析5例创伤性睾丸脱位的临床诊治过程并回顾文献。结果 5例患者中,仅2例患者得到及时确诊并手术,其中1例合并精索扭转及血管损伤,行睾丸切除术,另1例行睾丸复位固定术。其余3例睾丸脱位均被漏诊,漏诊时间1个月～6年;其中1例于伤后6年确诊并发现睾丸萎缩而行睾丸切除术;2例伤后1个月发现睾丸脱位行睾丸复位固定手术;3例行睾丸复位固定术患者术后随访0.5～4年,睾丸未见明显异常。结论创伤性睾丸脱位临床漏诊率高。详细体检可以避免漏诊,伤后早期手术简单易行,但时间较长后局部粘连明显,增加手术难度,更长时间的脱位睾丸容易萎缩并最终需要切除睾丸。

Objective To study the diagnosis and treatment of traumatic testis dislocation.Methods To analyze retrospectively of 5 cases of traumatic testis dislocation and review the literature.Results In all 5 cases,only 2 cases were diagnosed correctly at first visit,one case was given orchiectomy because of spermatic cord torsion and tesicular vessel injury;and the other case was given testis restoration.The other 3 cases were missed diagnosis at first visit with delayed period from one month to 6 yrs after injury.One case was treated with orchiectomy because of atrophy after 6yrs;the other 2 cases were treated by testis restoration.The testis of the 3 cases with restoration are in good condition with follow-up from 0.5 to 4yrs.Conclusion The miss diagnosis rate of testicular dislocation is quite high,and can be decreased by case history and total physical examination.The procedure is very simple for cases in the early stage after injury;but for the cases with long-time dislocation,the procedure maybe very difficult cause of fibrosis and adhesion,and orchiectomy should be proceeded for cases with testis atrophy.