The scrotum and testicles have a strong risk for injury. As boys reach puberty, the testicles and scrotum become larger, making it more likely for blunt injury related to a direct strike during contact sports. With the start of the new school year, football season and other contact sports begin. This time of year brings a greater risk for injury.
Sports-related genital injuries in boys and young men are uncommon. Most of these injuries occur to people who play contact sports without the proper gear to protect them.
The most common types of injury include a scrotal contusion, hematoma, testicular contusion and testicular fracture. Fractures occur when the rigid surface of the testicles are stricken with force. This causes an abrupt tear of testicular covering and extrusion of the seminiferous tubules. This is a surgical emergency. Urgent repair is needed. While most injuries do not cause endless damage to the testes, they can produce pain, loss of school time and possible need for surgery.
Surveys have shown about half the young men who play contact sports do not wear protective gear or athletic cups. This is mostly because they can be uncomfortable while playing sports. Sports most likely to cause a scrotal/testicular injury are football, lacrosse, ice hockey and baseball.
Right now there are no specific guidelines for use of protective gear in contact sports. Increasing awareness of genital injuries and the benefits of wearing protective gear during contact sports may help reduce the risk of testicular injuries. Boys and young adults should be educated on the choices for protective gear.
T. Ernesto Figueroa, MD, is Division Chief, Division of Pediatric Urology, Department of Surgery in the Nemours Children's Health System in the greater Philadelphia area.