Traumatic injuries of the epididymis in childhood and adolescence

Abstract

   Introduction. Injury to the epididymis is a rare type of injury, accounting for no more than 2–5 % of cases of injury to the scrotum. Preoperative diagnosis is difficult and effective in no more than 70 % of cases. Long-term results have no less negative consequences than damage to the testicular parenchyma proper due to the development of obstructive azoospermia. The low coverage of the issue in the literature and the sparseness of observations make it possible to consider the addition of information on this section of urgent andrology appropriate.

   Materials and methods. Seven cases of testicular appendage damage are presented, of which 5 are isolated and two are combined with testicular damage. The average age of the patients was 13 years and 5 months (9–17 years).

   Results and discussion. Several cases of appendage damage, both isolated and combined with testicular damage, are described. The possibilities of ultrasound diagnostics have been analyzed, for which the effectiveness is 71.4 %, which is significantly lower than for testicular damage. An active surgical tactic is demonstrated as the most optimal in case of violation of the capsule integrity. The presented injuries are considered as disrupting the function of the appendage with the development of obstructive azoospermia on the side of the injury.

   Conclusion. Testicular appendage injury is a poorly studied type of injury that requires further refinement of diagnostic criteria, development of therapeutic tactics and evaluation of treatment results. Active surgical tactics are the most optimal method of patient management. In all cases, the outcome of appendage injury with a violation of the integrity of its capsule should imply a high risk of obstructive azoospermia.