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Lower Urinary Tract Trauma
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===== <span style="color:#ff0000">History and Physical Exam</span> ===== * '''History''' ** Most patients complain of exquisite scrotal pain and nausea. *** '''β5% of spermatic cord torsions are believed to be precipitated by trauma'''; torsion should be considered in all cases of significant scrotal pain without signs or symptoms of major scrotal trauma * Physical exam ** Clinical examination of the scrotum following trauma can be limited due to significant scrotal swelling and patient discomfort ** Swelling and ecchymosis are variable, and the degree of hematoma may not correlate with the severity of testicular injury; absence does not entirely rule out testicular rupture, and contusion without fracture can manifest as significant bleeding. ** Scrotal hemorrhage and hematocele along with tenderness to palpation often limit a complete physical examination. ** '''A nonpalpable testis in a trauma patient should raise the possibility of dislocation outside the scrotum'''. Manual or surgical reduction of the displaced testis is indicated.
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