Traumatic Testicular Dislocation to the Medial Thigh: A Case Report with 8- Month Delayed Diagnosis

Traumatic Testicular Dislocation to the Medial Thigh: A Case Report with 8- Month Delayed Diagnosis | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Case Report Traumatic Testicular Dislocation to the Medial Thigh: A Case Report with 8- Month Delayed Diagnosis Ekrem Basaran¹, Emre Ediz¹, Ahmet Yildirim Balik¹, Dursun Baba¹, and 2 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6917536/v1 This work is licensed under a CC BY 4.0 License Status: Under Revision Version 1 posted 13 You are reading this latest preprint version Abstract Background Post-traumatic testicular dislocation is a very rare condition. In this case report, we present the delayed diagnosis and successful surgical treatment of a testicular dislocation following a motorcycle accident. Case presentation A 21-year-old male underwent surgery for a left testicular hematoma following a motorcycle accident, during which the right testis was found to be absent from the scrotum. Eight months after the trauma, he presented with pain in the medial aspect of the right thigh. Imaging revealed the right testis located subcutaneously in the proximal medial thigh. Open surgery successfully relocated the testis into the scrotum. Conclusion Traumatic testicular dislocation is a rare entity that may easily be overlooked in emergency department settings. Despite delayed diagnosis, testicular function can be preserved with an appropriate surgical approach. motorcycle accident traumatic testicular dislocation testicular injury delayed diagnosis Figures Figure 1 Figure 2 Figure 3 Introduction Traumatic testicular dislocation is a rare complication of blunt scrotal trauma. It was first described by Claubry in 1818 and has most frequently been reported following motorcycle accidents (1). In the past two centuries, 180 cases involving a total of 243 testes have been reported in the literature (1). The vast majority of these cases are unilateral and most commonly involve the inguinal canal. However, dislocations to other regions such as the superficial inguinal pouch, pelvic, penile, perineal, and abdominal areas have also been documented (2, 3). This condition can easily be missed in emergency settings and may lead to serious complications if not diagnosed promptly. In this case report, we present the delayed diagnosis and successful surgical management of testicular dislocation following a motorcycle accident, supported by relevant literature. Case Presentation A 21-year-old male presented to the emergency department of an external center on March 18, 2018, following a motorcycle accident. On admission, he was conscious and in good general condition. No additional pathology was identified during evaluation, and the patient was discharged. No scrotal imaging was performed at that time. Approximately one and a half months later, on May 4, 2018, he returned to the same hospital complaining of pain and swelling in the left testis. Physical examination revealed significant tenderness and swelling in the left scrotum. Doppler ultrasonography (USG) showed a normal-sized right testis with normal vascularity located within the scrotum, whereas the left testis showed a 9×7 cm hematoma with suspected torsion. The patient was hospitalized for scrotal exploration. Following a left scrotal incision, a 7–8 cm hematoma was evacuated. Upon incision of the tunica albuginea, the testis was found to have normal volume and consistency. During this procedure, the right testis was noted to be absent from both the scrotum and the inguinal canal. Intraoperative Doppler USG failed to localize the right testis. The patient, whose general condition was good and symptoms had improved, was discharged without further imaging or investigation. Approximately eight months post-trauma, on November 30, 2018, the patient presented to our clinic with severe pain in the medial aspect of the right thigh. Physical examination revealed swelling in this region (Fig. 1 ). Superficial USG showed that the right testis was absent from the scrotum and localized subcutaneously in the proximal medial thigh. Magnetic resonance imaging (MRI) demonstrated a 41×18 mm lobulated lesion in the upper medial thigh that appeared hypointense on T1-weighted and hyperintense on T2-weighted sequences, consistent with testicular tissue. The right testis was not visualized within the scrotum (Fig. 2 ). Considering the normal appearance of the right scrotum and the patient's history of the testis being in place prior to the trauma, a traumatic dislocation was suspected, leading to the planning of surgical intervention. On December 12, 2018, a surgical exploration of the right inguinal region and medial thigh was performed. The testis and epididymis were located in this area, and intraoperative Doppler USG confirmed adequate vascular supply. The testis and its appendages were successfully reduced into the right hemiscrotum (Fig. 3 ). At the first postoperative month, Doppler USG showed normal vascularity in the right testis and epididymis. The patient's symptoms had completely resolved, and he continues to be followed up in good health. Discussion Although rare, traumatic testicular dislocation is most commonly seen following motorcycle accidents. Compared to similar cases in the literature, this case is remarkable due to the diagnostic delay, unusual location of the dislocation, and successful surgical outcome. Such dislocations typically occur due to direct impact from the fuel tank to the perineal and scrotal regions during motorcycle crashes, where the testes are subjected to an upward and lateral force, potentially herniating between layers of the spermatic cord (4,5). According to the literature, diagnosis often depends on the attentiveness of the first physician evaluating the patient in the emergency department (1). These patients typically present with multiple systemic injuries, and a scrotal examination may easily be overlooked. In our case, the primary concern was a left testicular hematoma, and the absence of the right testis was not identified until intraoperative exploration. Even then, the testis could not be localized. Previous case reports have documented diagnoses made 3 days, 3 months, and 4 months after discharge (6). More recently, cases with diagnostic delays ranging from several weeks to even years have been reported (3). In one extraordinary case, bilateral dislocation was diagnosed 15 years post-trauma during an infertility evaluation due to azoospermia (7). Our case, with an 8-month delay, represents one of the longest delays documented in the literature. Although the inguinal canal is the most frequently reported location, dislocations have also been identified in the superficial inguinal pouch, pelvic, penile, perineal, and abdominal regions (8,9). In our patient, the location on the medial thigh is particularly rare. Treatment options include manual reduction or open surgical intervention. However, manual reduction has a reported success rate of only about 15%, and surgical repositioning is often required (9). Recent literature suggests that open orchiopexy has become the standard approach, especially in penile shaft dislocations (2). In our case, as with many others, manual reduction was unsuccessful, necessitating open surgical management. The dislocated testis, trapped between layers of the scrotum, may become adherent in delayed cases, making closed reduction impossible (8). In such cases, testicular viability may be compromised. A 2021 review analyzing 105 cases across 45 reports found that motorcycle accidents were responsible in approximately 80% of cases, and that physical examination was the most common diagnostic method (34.2%) (10). In the case with a 15-year delay, spermatogenesis gradually recovered following surgical reduction, and the patient later fathered a healthy child via natural intercourse after 40 months (7). This suggests that functional recovery may still be possible, even in long-standing dislocations. Undescended testes carry an approximately 10% lifetime risk of malignancy. This risk persists despite orchiopexy and necessitates lifelong follow-up (11). The precise incidence of malignancy in prolonged testicular dislocation remains unknown. For this reason, long-term follow-up was recommended for our patient. In comparison to existing literature, this case aligns with typical mechanisms (motorcycle trauma), while the dislocation site (medial thigh) and diagnostic delay (8 months) are relatively rare. The successful preservation of the testis following surgery further adds to its clinical significance (12,13). Conclusion Although traumatic testicular dislocation is a rare entity, it should be considered in patients presenting to the emergency department following motorcycle accidents or other forms of blunt abdominal trauma (14,15). This case highlights several critical points: bilateral scrotal palpation must be performed during initial evaluation; absence of a testis should prompt immediate imaging; surgical exploration should not be delayed, even in cases of late diagnosis; and long-term follow-up is essential for such patients. Abbreviations USG Ultrasonography MRI Magnetic Resonance Imaging Declarations Ethics approval and consent to participate Ethical approval was not required for this case report as per institutional guidelines for retrospective case reports, provided that patient consent was obtained. Clinical trial registration Not applicable. This is a retrospective case report and not a clinical trial. Consent for publication Written informed consent for the publication of this case report and accompanying images was obtained from the patient. Availability of data and materials All the data generated or analyzed during this study are included in this published article. Competing interests The authors declare that they have no competing interests. Funding The authors received no specific funding for this work. Authorship contributions EE and AYB obtained and analyzed clinical data. EE and EB wrote the manuscript. DB, EB, MAO and EE designed and created the figures. EB, EE and ATT designed and supervised the study and edited the manuscript. All the authors have read and approved the final manuscript. References Subramaniam S, Ab Khalil MK, Zakaria J, Hayati F. Managing traumatic testicular dislocations: what we know after two centuries. BMJ Case Reports CP. 2020;13(11):e236801. Chi Z-P, Zhang Y-H. Penile traumatic testicular dislocation: a case report. Journal of International Medical Research. 2024;52(2):03000605241232916. Wang Q, Alshayyah RW, Lv H, Yu Y, Liu X, Yang B. Delayed diagnosis and treatment of traumatic testicular dislocation: a case report and literature review. Frontiers in Surgery. 2021;8:721192. Sehrawat S, Sharma V, Srivastava GS, Farooque K. Unilateral Traumatic Testicular Dislocation in a Patient of Pelvic Diastasis and Spine Fracture in an Adult: A Case Report and Review of Literature. Journal of Orthopaedic Case Reports. 2024;14(8):99. Hsu M-W, Hsieh P-F, Tsai L-H. A Rare and Easily Overlooked Case of Bilateral Traumatic Testicular Dislocation and an Alternative Viewpoint on Delayed Management. Medicina. 2023;59(5):892. Schwartz SL, Faerber GJ. Dislocation of the testis as a delayed presentation of scrotal trauma. Urology. 1994;43(5):743-5. Sakamoto H, Iwasaki S, Kushima M, Shichijo T, Ogawa Y. Traumatic bilateral testicular dislocation: a recovery of spermatogenesis by orchiopexy 15 years after the onset. Fertility and sterility. 2008;90(5):2009. e9-. e11. Naik MN, Shaikh OH, Vijayakumar C, Kumbhar US. Rare case of traumatic bilateral testicular dislocation. BMJ Case Reports CP. 2021;14(8):e244085. Colalillo G, Pletto S, Laudazi M, Asimakopoulos AD. Traumatic testicular dislocation in the abdomen: diagnosis and management. BMJ Case Reports CP. 2023;16(9):e254530. Chiu Y-C, Lin Y-K. Traumatic testicular dislocation: a case report and literature review. Medicine. 2022;101(18):e29137. El Anzaoui J, Cherraqi A, Jamali M, Andour H, Eladioui G, Doulhousne H. Pediatric testicular posttraumatic dislocation presenting as a testicular torsion: A case report. Urology Case Reports. 2023;48:102396. Matzek BA, Linklater DR. Traumatic testicular dislocation after minor trauma in a pediatric patient. The Journal of Emergency Medicine. 2013;45(4):537-40. Al Saeedi A, Khalil IA, Omran A, Alobaidy A, Al Ansari A, Al Saeedi AK, et al. A Literature Review and Two Case Reports: Is Traumatic Dislocation of the Testes a Surgical Emergency? Cureus. 2022;14(5). Gómez RG, Storme O, Catalán G, Marchetti P, Djordjevic M. Traumatic testicular dislocation. International urology and nephrology. 2014;46:1883-7. Ko S-F, Ng S-H, Wan Y-L, Huang C-C, Lee T-Y, Kung C-T, et al. Testicular dislocation: an uncommon and easily overlooked complication of blunt abdominal trauma. Annals of emergency medicine. 2004;43(3):371-5. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Under Revision Version 1 posted Editorial decision: Revision requested 26 May, 2026 Reviews received at journal 28 Feb, 2026 Reviews received at journal 07 Aug, 2025 Reviewers agreed at journal 07 Aug, 2025 Reviewers agreed at journal 02 Aug, 2025 Reviews received at journal 31 Jul, 2025 Reviewers agreed at journal 31 Jul, 2025 Reviewers agreed at journal 31 Jul, 2025 Reviewers invited by journal 31 Jul, 2025 Editor invited by journal 01 Jul, 2025 Editor assigned by journal 28 Jun, 2025 Submission checks completed at journal 28 Jun, 2025 First submitted to journal 17 Jun, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6917536","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Case Report","associatedPublications":[],"authors":[{"id":494708681,"identity":"9fef94b7-b6e7-48a9-8d7e-154e86225512","order_by":0,"name":"Ekrem Basaran¹","email":"","orcid":"","institution":"Duzce University","correspondingAuthor":false,"prefix":"","firstName":"Ekrem","middleName":"","lastName":"Basaran¹","suffix":""},{"id":494708682,"identity":"7bcfd702-cd39-45be-9fda-920c8376215b","order_by":1,"name":"Emre 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22:08:16","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-6917536/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-6917536/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":88408672,"identity":"1c3e77c7-4608-4cfd-9ee9-75ecef3ffa28","added_by":"auto","created_at":"2025-08-06 08:14:24","extension":"jpg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":51186,"visible":true,"origin":"","legend":"\u003cp\u003ePhysical Examination: Physical examination showing a swelling on the inner surface of the right thigh.\u003c/p\u003e","description":"","filename":"1.jpg","url":"https://assets-eu.researchsquare.com/files/rs-6917536/v1/4ca9bc5b6742860f5f273305.jpg"},{"id":88408673,"identity":"1721eeeb-c234-4cd7-88ae-5d3aececf68e","added_by":"auto","created_at":"2025-08-06 08:14:24","extension":"jpg","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":53833,"visible":true,"origin":"","legend":"\u003cp\u003eMagnetic Resonance Imaging (MRI): Appearance of the dislocated testis in the upper medial region of the right thigh, located between the subcutaneous tissue and muscle structures.\u003c/p\u003e","description":"","filename":"2.jpg","url":"https://assets-eu.researchsquare.com/files/rs-6917536/v1/311d60d9a28738f49e0923c9.jpg"},{"id":88410180,"identity":"6e32c746-53d9-4176-9bf2-e53594d273d6","added_by":"auto","created_at":"2025-08-06 08:22:24","extension":"jpg","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":79676,"visible":true,"origin":"","legend":"\u003cp\u003eIntraoperative View: Mobilization of the right testis and its appendages, prepared for scrotal reduction.\u003c/p\u003e","description":"","filename":"3.jpg","url":"https://assets-eu.researchsquare.com/files/rs-6917536/v1/4d926f0c14d9bf2f9c063e78.jpg"},{"id":88411950,"identity":"d576e466-97d4-4e93-9a63-656174a2a098","added_by":"auto","created_at":"2025-08-06 08:30:28","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":531011,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6917536/v1/5eff1279-c34f-4710-a2e5-9f897bfc8a75.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Traumatic Testicular Dislocation to the Medial Thigh: A Case Report with 8- Month Delayed Diagnosis","fulltext":[{"header":"Introduction","content":"\u003cp\u003eTraumatic testicular dislocation is a rare complication of blunt scrotal trauma. It was first described by Claubry in 1818 and has most frequently been reported following motorcycle accidents (1). In the past two centuries, 180 cases involving a total of 243 testes have been reported in the literature (1). The vast majority of these cases are unilateral and most commonly involve the inguinal canal. However, dislocations to other regions such as the superficial inguinal pouch, pelvic, penile, perineal, and abdominal areas have also been documented (2, 3).\u003c/p\u003e\u003cp\u003eThis condition can easily be missed in emergency settings and may lead to serious complications if not diagnosed promptly. In this case report, we present the delayed diagnosis and successful surgical management of testicular dislocation following a motorcycle accident, supported by relevant literature.\u003c/p\u003e"},{"header":"Case Presentation","content":"\u003cp\u003eA 21-year-old male presented to the emergency department of an external center on March 18, 2018, following a motorcycle accident. On admission, he was conscious and in good general condition. No additional pathology was identified during evaluation, and the patient was discharged. No scrotal imaging was performed at that time.\u003c/p\u003e\u003cp\u003eApproximately one and a half months later, on May 4, 2018, he returned to the same hospital complaining of pain and swelling in the left testis. Physical examination revealed significant tenderness and swelling in the left scrotum. Doppler ultrasonography (USG) showed a normal-sized right testis with normal vascularity located within the scrotum, whereas the left testis showed a 9\u0026times;7 cm hematoma with suspected torsion. The patient was hospitalized for scrotal exploration.\u003c/p\u003e\u003cp\u003eFollowing a left scrotal incision, a 7\u0026ndash;8 cm hematoma was evacuated. Upon incision of the tunica albuginea, the testis was found to have normal volume and consistency. During this procedure, the right testis was noted to be absent from both the scrotum and the inguinal canal. Intraoperative Doppler USG failed to localize the right testis. The patient, whose general condition was good and symptoms had improved, was discharged without further imaging or investigation.\u003c/p\u003e\u003cp\u003eApproximately eight months post-trauma, on November 30, 2018, the patient presented to our clinic with severe pain in the medial aspect of the right thigh. Physical examination revealed swelling in this region (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). Superficial USG showed that the right testis was absent from the scrotum and localized subcutaneously in the proximal medial thigh. Magnetic resonance imaging (MRI) demonstrated a 41\u0026times;18 mm lobulated lesion in the upper medial thigh that appeared hypointense on T1-weighted and hyperintense on T2-weighted sequences, consistent with testicular tissue. The right testis was not visualized within the scrotum (Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003eConsidering the normal appearance of the right scrotum and the patient's history of the testis being in place prior to the trauma, a traumatic dislocation was suspected, leading to the planning of surgical intervention.\u003c/p\u003e\u003cp\u003eOn December 12, 2018, a surgical exploration of the right inguinal region and medial thigh was performed. The testis and epididymis were located in this area, and intraoperative Doppler USG confirmed adequate vascular supply. The testis and its appendages were successfully reduced into the right hemiscrotum (Fig.\u0026nbsp;\u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003eAt the first postoperative month, Doppler USG showed normal vascularity in the right testis and epididymis. The patient's symptoms had completely resolved, and he continues to be followed up in good health.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eAlthough rare, traumatic testicular dislocation is most commonly seen following motorcycle accidents. Compared to similar cases in the literature, this case is remarkable due to the diagnostic delay, unusual location of the dislocation, and successful surgical outcome. Such dislocations typically occur due to direct impact from the fuel tank to the perineal and scrotal regions during motorcycle crashes, where the testes are subjected to an upward and lateral force, potentially herniating between layers of the spermatic cord (4,5).\u003c/p\u003e\u003cp\u003eAccording to the literature, diagnosis often depends on the attentiveness of the first physician evaluating the patient in the emergency department (1). These patients typically present with multiple systemic injuries, and a scrotal examination may easily be overlooked. In our case, the primary concern was a left testicular hematoma, and the absence of the right testis was not identified until intraoperative exploration. Even then, the testis could not be localized. Previous case reports have documented diagnoses made 3 days, 3 months, and 4 months after discharge (6). More recently, cases with diagnostic delays ranging from several weeks to even years have been reported (3). In one extraordinary case, bilateral dislocation was diagnosed 15 years post-trauma during an infertility evaluation due to azoospermia (7). Our case, with an 8-month delay, represents one of the longest delays documented in the literature.\u003c/p\u003e\u003cp\u003eAlthough the inguinal canal is the most frequently reported location, dislocations have also been identified in the superficial inguinal pouch, pelvic, penile, perineal, and abdominal regions (8,9). In our patient, the location on the medial thigh is particularly rare. Treatment options include manual reduction or open surgical intervention. However, manual reduction has a reported success rate of only about 15%, and surgical repositioning is often required (9). Recent literature suggests that open orchiopexy has become the standard approach, especially in penile shaft dislocations (2).\u003c/p\u003e\u003cp\u003eIn our case, as with many others, manual reduction was unsuccessful, necessitating open surgical management. The dislocated testis, trapped between layers of the scrotum, may become adherent in delayed cases, making closed reduction impossible (8). In such cases, testicular viability may be compromised. A 2021 review analyzing 105 cases across 45 reports found that motorcycle accidents were responsible in approximately 80% of cases, and that physical examination was the most common diagnostic method (34.2%) (10). In the case with a 15-year delay, spermatogenesis gradually recovered following surgical reduction, and the patient later fathered a healthy child via natural intercourse after 40 months (7). This suggests that functional recovery may still be possible, even in long-standing dislocations.\u003c/p\u003e\u003cp\u003eUndescended testes carry an approximately 10% lifetime risk of malignancy. This risk persists despite orchiopexy and necessitates lifelong follow-up (11). The precise incidence of malignancy in prolonged testicular dislocation remains unknown. For this reason, long-term follow-up was recommended for our patient. In comparison to existing literature, this case aligns with typical mechanisms (motorcycle trauma), while the dislocation site (medial thigh) and diagnostic delay (8 months) are relatively rare. The successful preservation of the testis following surgery further adds to its clinical significance (12,13).\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eAlthough traumatic testicular dislocation is a rare entity, it should be considered in patients presenting to the emergency department following motorcycle accidents or other forms of blunt abdominal trauma (14,15). This case highlights several critical points: bilateral scrotal palpation must be performed during initial evaluation; absence of a testis should prompt immediate imaging; surgical exploration should not be delayed, even in cases of late diagnosis; and long-term follow-up is essential for such patients.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cdiv class=\"DefinitionList\"\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eUSG\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eUltrasonography\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eMRI\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eMagnetic Resonance Imaging\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003c/div\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eEthical approval was not required for this case report as per institutional guidelines for retrospective case reports, provided that patient consent was obtained.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eClinical trial registration\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable. This is a retrospective case report and not a clinical trial.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWritten informed consent for the publication of this case report and accompanying images was obtained from the patient.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll the data generated or analyzed during this study are included in this published article.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors received no specific funding for this work.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthorship contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eEE and AYB obtained and analyzed clinical data. EE and EB wrote the manuscript. DB, EB, MAO and EE designed and created the figures. EB, EE and ATT designed and supervised the study and edited the manuscript. All the authors have read and approved the final manuscript.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n \u003cli\u003eSubramaniam S, Ab Khalil MK, Zakaria J, Hayati F. Managing traumatic testicular dislocations: what we know after two centuries. BMJ Case Reports CP. 2020;13(11):e236801.\u003c/li\u003e\n \u003cli\u003eChi Z-P, Zhang Y-H. Penile traumatic testicular dislocation: a case report. Journal of International Medical Research. 2024;52(2):03000605241232916.\u003c/li\u003e\n \u003cli\u003eWang Q, Alshayyah RW, Lv H, Yu Y, Liu X, Yang B. Delayed diagnosis and treatment of traumatic testicular dislocation: a case report and literature review. Frontiers in Surgery. 2021;8:721192.\u003c/li\u003e\n \u003cli\u003eSehrawat S, Sharma V, Srivastava GS, Farooque K. Unilateral Traumatic Testicular Dislocation in a Patient of Pelvic Diastasis and Spine Fracture in an Adult: A Case Report and Review of Literature. Journal of Orthopaedic Case Reports. 2024;14(8):99.\u003c/li\u003e\n \u003cli\u003eHsu M-W, Hsieh P-F, Tsai L-H. A Rare and Easily Overlooked Case of Bilateral Traumatic Testicular Dislocation and an Alternative Viewpoint on Delayed Management. Medicina. 2023;59(5):892.\u003c/li\u003e\n \u003cli\u003eSchwartz SL, Faerber GJ. Dislocation of the testis as a delayed presentation of scrotal trauma. Urology. 1994;43(5):743-5.\u003c/li\u003e\n \u003cli\u003eSakamoto H, Iwasaki S, Kushima M, Shichijo T, Ogawa Y. Traumatic bilateral testicular dislocation: a recovery of spermatogenesis by orchiopexy 15 years after the onset. Fertility and sterility. 2008;90(5):2009. e9-. e11.\u003c/li\u003e\n \u003cli\u003eNaik MN, Shaikh OH, Vijayakumar C, Kumbhar US. Rare case of traumatic bilateral testicular dislocation. BMJ Case Reports CP. 2021;14(8):e244085.\u003c/li\u003e\n \u003cli\u003eColalillo G, Pletto S, Laudazi M, Asimakopoulos AD. Traumatic testicular dislocation in the abdomen: diagnosis and management. BMJ Case Reports CP. 2023;16(9):e254530.\u003c/li\u003e\n \u003cli\u003eChiu Y-C, Lin Y-K. Traumatic testicular dislocation: a case report and literature review. Medicine. 2022;101(18):e29137.\u003c/li\u003e\n \u003cli\u003eEl Anzaoui J, Cherraqi A, Jamali M, Andour H, Eladioui G, Doulhousne H. Pediatric testicular posttraumatic dislocation presenting as a testicular torsion: A case report. Urology Case Reports. 2023;48:102396.\u003c/li\u003e\n \u003cli\u003eMatzek BA, Linklater DR. Traumatic testicular dislocation after minor trauma in a pediatric patient. The Journal of Emergency Medicine. 2013;45(4):537-40.\u003c/li\u003e\n \u003cli\u003eAl Saeedi A, Khalil IA, Omran A, Alobaidy A, Al Ansari A, Al Saeedi AK, et al. A Literature Review and Two Case Reports: Is Traumatic Dislocation of the Testes a Surgical Emergency? Cureus. 2022;14(5).\u003c/li\u003e\n \u003cli\u003eG\u0026oacute;mez RG, Storme O, Catal\u0026aacute;n G, Marchetti P, Djordjevic M. Traumatic testicular dislocation. International urology and nephrology. 2014;46:1883-7.\u003c/li\u003e\n \u003cli\u003eKo S-F, Ng S-H, Wan Y-L, Huang C-C, Lee T-Y, Kung C-T, et al. Testicular dislocation: an uncommon and easily overlooked complication of blunt abdominal trauma. Annals of emergency medicine. 2004;43(3):371-5.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-urology","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"buro","sideBox":"Learn more about [BMC Urology](http://bmcurol.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/buro/default.aspx","title":"BMC Urology","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"motorcycle accident, traumatic testicular dislocation, testicular injury, delayed diagnosis","lastPublishedDoi":"10.21203/rs.3.rs-6917536/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6917536/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eBackground\u003c/p\u003e\n\u003cp\u003ePost-traumatic testicular dislocation is a very rare condition. In this case report, we present the delayed diagnosis and successful surgical treatment of a testicular dislocation following a motorcycle accident.\u003c/p\u003e\n\u003cp\u003eCase presentation\u003c/p\u003e\n\u003cp\u003eA 21-year-old male underwent surgery for a left testicular hematoma following a motorcycle accident, during which the right testis was found to be absent from the scrotum. Eight months after the trauma, he presented with pain in the medial aspect of the right thigh. Imaging revealed the right testis located subcutaneously in the proximal medial thigh. Open surgery successfully relocated the testis into the scrotum.\u003c/p\u003e\n\u003cp\u003eConclusion\u003c/p\u003e\n\u003cp\u003eTraumatic testicular dislocation is a rare entity that may easily be overlooked in emergency department settings. Despite delayed diagnosis, testicular function can be preserved with an appropriate surgical approach.\u003c/p\u003e","manuscriptTitle":"Traumatic Testicular Dislocation to the Medial Thigh: A Case Report with 8- Month Delayed Diagnosis","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-08-06 08:14:19","doi":"10.21203/rs.3.rs-6917536/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2026-05-26T12:33:53+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-02-28T15:11:38+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-08-07T23:55:11+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"139129721483204157782056312206376053081","date":"2025-08-07T13:51:59+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"65764504716764379290288030214736558122","date":"2025-08-02T14:16:11+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-08-01T03:11:36+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"31640216277071494477561188924486073221","date":"2025-08-01T01:13:43+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"27233972456903863502378557125602958872","date":"2025-07-31T13:19:00+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-07-31T13:14:44+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-07-01T06:40:14+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-06-28T16:13:19+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-06-28T16:11:25+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Urology","date":"2025-06-17T21:59:25+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-urology","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"buro","sideBox":"Learn more about [BMC Urology](http://bmcurol.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/buro/default.aspx","title":"BMC Urology","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"6b9e6167-f684-4b22-8b61-106a8521d4f2","owner":[],"postedDate":"August 6th, 2025","published":true,"recentEditorialEvents":[{"type":"decision","content":"Revision requested","date":"2026-05-26T12:33:53+00:00","index":"","fulltext":""}],"rejectedJournal":[],"revision":"","amendment":"","status":"in-revision","subjectAreas":[],"tags":[],"updatedAt":"2026-05-26T12:39:49+00:00","versionOfRecord":[],"versionCreatedAt":"2025-08-06 08:14:19","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-6917536","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6917536","identity":"rs-6917536","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}