PENETRATING TRAUMA TO THE MALE EXTERNAL GENITALIA

Background: We report on 10 patients with penetrating trauma to the ex ternal genitalia. Initial evaluation and management, operative finding s, and treatment outcomes are reviewed. Methods: We retrospectively re viewed the medical records of all patients presenting to our facility with penetrating trauma to the external genitalia since 1988. Results: Of the 40 patients reviewed, 22 sustained isolated scrotal trauma, 10 sustained isolated penile trauma, and 8 had both scrotal and penile i njuries. Twenty-nine of the 30 men with scrotal injuries underwent sur gical exploration, and 21 of these were found to have injuries to the spermatic cord or testes (in 2 patients, bilateral injuries were noted ). The testicular salvage rate was 35%. Penile trauma occurred in 18 p atients. Eight corporal injuries and four urethral injuries were manag ed with debridement and primary repair. Erection and normal voiding wa s present in all men undergoing reconstruction who returned for follow -up. Thirty-eight percent of tested patients were positive for hepatit is B, C, or both. More than 60% of tested patients were legally intoxi cated at the time of injury. Injuries separate from genitourinary trau ma were identified in 72% of the men. Conclusion: Early surgical explo ration with conservative debridement and primary repair of injured str uctures is recommended for most men who sustain penetrating injuries t o the external genitalia. Selected patients with superficial injuries can be managed nonoperatively, but delayed wound complications are not uncommon. Although universal precautions are recommended for all pati ents, the high prevalence of hepatitis B and C in this group reemphasi zes their importance. Long-term follow-up in this largely young, mobil e, indigent population was poor.