Zhang Xiangxiang, Li Fanfan, Zhang Mao, Li Hengping
Department of Urology, Gansu Provincial Hospital, Lanzhou, Gansu, China.
Gansu University of Chinese Medicine, Lanzhou, China.
Int J Surg Case Rep. 2025 Oct;135:111754. doi: 10.1016/j.ijscr.2025.111754. Epub 2025 Aug 5.
Testicular rupture caused by blunt scrotal trauma can be repaired routinely, but for severe testicular rupture often accompanied by a large area of tunica albuginea defect, it is impossible to suture the tunica albuginea without tension unless excess normal testicular tissue is removed. This case report highlights the surgical challenge of using a pedicled tunica vaginalis in the case of severe tunica albuginea defect in testicular rupture.
Two underage boys both experienced severe pain in the scrotum due to trauma, and ultrasound examination showed testicular rupture. Emergency surgical exploration was performed, and severe testicular rupture was observed during the operation, with a large area of tunica albuginea defect that could not be repaired routinely. After trimming the necrotic testicular tissue, a pedicled testicular sheath was sutured to the residual tunica albuginea. After one year of postoperative follow-up, the recovery was good and hormone levels were normal.
Surgical repair of testicular rupture presents certain challenges, especially for severe tunica albuginea defects. The use of a pedicled testicular tunica vaginalis can more easily solve this problem, but the location and size of the tunica vaginalis need to be designed during surgery, especially to ensure blood supply to the tunica vaginalis.
For severe testicular rupture, the use of pedicle testicular sheath repair is a recommended option, but it requires certain surgical techniques.
钝性阴囊外伤导致的睾丸破裂通常可常规修复，但对于常伴有大面积白膜缺损的严重睾丸破裂，除非切除多余的正常睾丸组织，否则无法无张力缝合白膜。本病例报告强调了在睾丸破裂伴严重白膜缺损的情况下使用带蒂鞘膜的手术挑战。
两名未成年男孩均因外伤出现阴囊剧痛，超声检查显示睾丸破裂。进行了急诊手术探查，术中观察到严重的睾丸破裂，有大面积白膜缺损无法常规修复。修剪坏死的睾丸组织后，将带蒂睾丸鞘膜缝合至残留的白膜上。术后随访一年，恢复良好，激素水平正常。
睾丸破裂的手术修复存在一定挑战，尤其是对于严重的白膜缺损。使用带蒂睾丸鞘膜可更轻松地解决此问题，但手术中需要设计鞘膜的位置和大小，尤其要确保鞘膜的血供。
对于严重睾丸破裂，使用带蒂睾丸鞘膜修复是一种推荐的选择，但需要一定的手术技巧。
