Tunica vaginalis graft use for repair of testicular rupture after blunt trauma: A report of two cases and literature review.

Abstract

Background: 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.

Case presentation: 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.

Discussion: 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.

Conclusion: For severe testicular rupture, the use of pedicle testicular sheath repair is a recommended option, but it requires certain surgical techniques.