Open AccessIntra-Testicular Papaverine Injection for Testicular Salvage after Blunt Testicular Trauma: A Case Report
Author(s) -
Kevin Keating,
Paulette Dreher,
Jason A. Levy,
Brian McGreen,
Daniel C. Edwards,
Susan Tarry
Publication year - 2019
Publication title -
current urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.476
H-Index - 13
eISSN - 1661-7657
pISSN - 1661-7649
DOI - 10.1159/000499283
Subject(s) - medicine , papaverine , blunt , testicular torsion , testicle , surgery , scrotum , blunt trauma , tunica albuginea (penis) , hematoma , penis , anesthesia , anatomy
Blunt trauma is the most common mechanism of injury to the scrotum and testicle. Surgical exploration with primary repair, hematoma evacuation, and de-torsion are common surgical interventions. A 20-year-old male with no previous medical history presented after a high-speed motor vehicle collision. Ultrasonography demonstrated heterogeneous changes of the tunica albuginea and decreased arterial flow to bilateral testicles. He was subsequently taken to the operating room for surgical exploration, which revealed bilateral mottled testes with questionable viability. Papaverine was injected into each testicle, which resulted in visibly increased perfusion and subsequent preservation of the testicles. Conclusion: Current evidence on the use of papaverine is isolated to testicular torsion. Additional research should be conducted on the use of papaverine in blunt testicular trauma. Papaverine injection may be a valuable treatment option when inadequate perfusion is observed intra-operatively.