Sports-Related Testicular Trauma: Acute Management And Long-Term Reproductive Consequences - a Narrative Review

Background. Testicular trauma is uncommon but clinically significant, occurring in contact and non-contact sports, motor sports, and cycling. Scrotal anatomy limits severe injury frequency, yet blunt impact, straddle mechanisms, and occasional penetrating trauma can cause hematocele, testicular fracture, rupture, dislocation, and torsion, each with distinct implications for organ salvage and fertility.Aim. To synthesise the epidemiology, mechanisms, diagnostic pathways, acute management, and long-term reproductive and endocrine consequences of sports-related testicular trauma.Materials and Methods. Narrative review of peer-reviewed English-language publications, including trauma-registry series, retrospective and prospective cohorts, case reports/series, systematic reviews, and reproductive-endocrinology literature on testicular/scrotal trauma, ischemia-reperfusion oxidative stress, and male infertility, grouped thematically by mechanism, diagnostic modality, management strategy, and outcome domain.Results. Blunt trauma predominates in sport, with testicular rupture salvage rates falling sharply when surgical exploration is delayed beyond 72 hours. Ultrasonography, though imperfect, remains the diagnostic cornerstone. Discipline-specific patterns emerge for cycling-related compressive injury, contact-sport rupture, and rare catastrophic gunshot or crush injuries. Long-term data show persistent risks of atrophy, subfertility, and endocrine dysfunction even after anatomically successful salvage.Conclusions. Prompt recognition, sonographic triage, and early surgical exploration are the strongest determinants of testicular salvage, while long-term reproductive surveillance remains inconsistently implemented and warrants greater clinical attention.