Traumatic bilateral testicular amputation in a 31 year old male: A case report

INTRODUCTION AND IMPORTANCE: Testicular loss following assault is a very rare occurrence and uncommon in the low income countries. Testicular amputation is usually associated with blast injuries, sexual violence and self-mutilation in psychiatric cases. Management involves a multidisciplinary approach and is focused on resuscitation, aggressive debridement, testosterone supplementation, and reconstructive surgery. CASE PRESENTATION: We present a 31 year old male referred to the emergency department of a Regional Referral Hospital in western Uganda with a history of trauma to his scrotum. The patient had been well till 16 h prior to presentation when he was attacked by unknown assailants who broke into his house in the night. The patient was reportedly beaten before his scrotum was pulled and amputated with eventual profuse bleeding. Evacuation of approximately 150 cc hematoma was done plus debridement of necrotic testes and achieving hemostasis. DISCUSSION AND CONCLUSION: To the best of our knowledge, this was the first reported case of bilateral traumatic testicular amputation as a result of assault. Revascularization with micro-vascular techniques can be done if the patient presents early, but due to late presentation, the patient was only managed with aggressive debridement, reconstruction and testosterone supplementation.