Blunt injuries to the scrotum usually occur in patients who are younger than 50 years of age as a result of an athletic injury; a straddle injury; an automobile, motorcycle, or industrial accident; or an assault. Patients present with various degrees of pain, ecchymoses, and swelling as well as faintness, nausea, or vomiting (Fig. 77.1). The symptoms from minor injuries will gradually resolve on their own after 1 to 2 hours. In the more severe injury of testicular rupture, pain is usually severe, and the scrotal sac may appear full, ecchymotic, and very tender.

 

The presence of both testicular swelling and tenderness suggests more significant testicular injury; however, testicular rupture can be present in the absence of tenderness.