What are the concerning features here?
There are plenty of findings! Defect in the tunica albuginea lining the right testis, with extrusion of the testis. Increased size and vascularity, with a small anterior contusion. Complex haematocele.
Who do you need to call urgently?
The urological surgeons need to know these results immediately, and ideally would accompany the patient to review the images with you in real time.
Why is urgent intervention recommended?
If repair or salvage is delayed, risks include reduced sperm count, endocrine abnormalities (including elevated LH and FSH), and there is a theoretical risk of developing anti-sperm antibodies which disrupt spermatogenesis. In some cases, orchidectomy is required, although testicular salvage is preferred.
Normal left testis and associated structures.
Rupture of right testis, with tunica albuginea defect in the inferomedial portion of the testis. The testis is approximately 50% larger in volume than the left.
Increased vascularity of the right testis, apart from at a heterogenous, hypoechoic component anteriorly with little flow, likely small contusion/haematoma.
Complex right haematocele.
Relatively preserved epididymal head.