ACCURACY OF ULTRASOUND DIAGNOSIS AFTER BLUNT TESTICULAR TRAUMA

The aim of this study is to determine the value of ultrasound evaluati on for the diagnosis of testis rupture due to blunt scrotal trauma. We reviewed 16 operated cases of blunt scrotal trauma with hematocele, w hich were evaluated by ultrasound preoperatively. In 2 cases a tunica albuginea rupture was correctly diagnosed by ultrasonography but there were 2 false-positive and 5 false-negative diagnoses of rupture. Syst ematic exploration of the 16 cases revealed testicular rupture in 7, s imple hematocele in 7 and hematocele associated with spermatic cord in jury in 2. In 2 cases orchiectomy was necessary. From our experience t he accuracy rate of ultrasound evaluation of blunt scrotal trauma was 56%, with a 58% negative predictive value. Considering these results, ultrasound examination of blunt scrotal trauma with hematocele is not sufficiently accurate to eliminate surgical exploration and, therefore , we recommend early surgical exploration as primary therapy in these cases.