Journal of Emergencies, Trauma, and Shock
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CASE REPORT
Year : 2010  |  Volume : 3  |  Issue : 2  |  Page : 199-203

Threatened fertility and gonadal function after a polytraumatic, life-threatening injury


1 Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI - 53705, USA
2 Department of Urology, University of Wisconsin School of Medicine and Public Health, Madison, WI - 53705, USA

Correspondence Address:
Lee D Faucher
Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI - 53705
USA
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0974-2700.62110

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Trauma literature regarding management of genitalia trauma affecting future fertility and gonadal function in the face of coexisting life-threatening injuries is underdeveloped. We present a unique case that necessitated integrative management of a 24-year-old male who became entangled within the blades of a manure spreader and presented with life-threatening trauma in addition to severe genital trauma, including penile degloving, bilateral testicular avulsion and bilateral spermatic cord laceration. During the initial stabilization and surgical management, urology and plastic surgery were consulted to assess the urogenital injuries. Together, the surgical team orchestrated potentially life-saving interventions while successfully performing both a testicular sperm extraction and a testicular revascularization. Viable sperm was collected on the day of surgery and initial follow-up showed preserved sexual function and adequate perfusion to the testicle. This report presents a case and provides a review discussing the management of traumatic genital injuries and the importance of early involvement of surgical specialties in genitalia trauma to optimize future fertility and gonadal function. The literature search was performed in August 2008 using Medline for articles only in English, including any of the following terms: polytrauma, trauma, penis, testicle, degloving, avulsion, spermatic cord, laceration, fertility, reproduction or revascularization.


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