Forensic aspects of trauma to the male external genitalia (TMEG), analysis of a series of 84 cases

OBJECTIVES: Describe the medico-legal aspects of trauma to the male external genitalia by specifying their epidemiological, clinical, paraclinical, therapeutic and evolutionary characteristics. MATERIALS AND METHODS: Retrospective study spread over a period of 3 years (2017–2019) concerning adult patients with trauma to the male external genitalia consulting in the surgical emergency and forensic medicine departments of the Ibn Rochd University Hospital Center in Casablanca. RESULTS: We collected 84 cases of TMEG within the framework of evaluation of bodily injury aimed at fixing the duration of Total Temporary Incapacity (TTI) and the rate of Permanent Partial Incapacity (PPI). There was a predominance of bursa trauma (85.7%) followed by penis trauma (14.5%). The average age of the patients was 39 years (17–61 years). Road accidents are the cause of 42% of cases. Regarding bursa trauma, the clinical symptomatology was dominated by pain (100%) and increased scrotal volume (50%). Scrotal ultrasound found the main lesion to be scrotal hematomas (35.71%) followed by ruptures of the tunica albuginea (9.5%). Surgical exploration was indicated in 45.23% of cases, of which (38%) was conservative treatment. For trauma to the penis, the clinical examination revealed 1 case of fracture of the cavernous body, a hematoma of the penis in only 1 patient, a superficial wound of the penis in 1 patient and the rest of the patients (9 cases) showed no lesions. Surgical treatment was indicated in only one patient. The average duration of temporary total incapacity was 17.5 days and the average rate of partial permanent incapacity was 4%. CONCLUSION: Physicians who are experts in the evaluation of bodily injury are frequently confronted with the evaluation of the damage resulting from the TMEG. The medico-legal evaluation of these traumas remains difficult and very varied requiring a perfect knowledge of the mechanisms of these traumas, of the therapeutic and evolutionary principles helping in the judicial decision.