[External genital injuries during childhood].

Abstract

OBJECTIVE: Genitalia trauma are relatively frequent pediatric emergencies. There is a wide spectrum of lesions that can be produced. The purpose of this study is to descriptively analyse our experience with pediatric urologic trauma over the last five years. METHODS: We review 152 cases of male children ages 1 to 15 years old who presented with external genitalia trauma at our hospital's paediatric emergency room and required urologic evaluation or treatment. All cases were evaluated for type of lesion, mechanism of trauma production, complementary diagnostic tests performed and treatment: conservative or surgery. RESULTS: 33.5% of lesions were prepucial or penile, and the remainder 66.5% were to the scrotum or its content. In 60 cases (61.2% of scrotal trauma) a scrotal ultrasound was performed. Treatment was conservative in 73.1% cases, and in the remainder 41 boys primary suture or surgical exploration were performed in cases of hematoma, parenchymal rupture, important penile-scrotal tears, and in one case of suprapubic cellulitis secondary to a prepucial wound. A deferred orchiectomy was necessary in one case only: a case with hematocele in which an initial surgical examination was not performed. CONCLUSIONS: External genitalia trauma during childhood are usually mild and the majority of cases do not request surgical treatment. When in doubt about parenchymal involvement or existence of hematocele surgical exploration must be performed trying to preserve testicular integrity.