Z. J. Hellmann1, N. L. Maassel1, D. H. Stitelman2, A. B. Hittelman3, D. G. Solomon2 1Yale University School Of Medicine, Department Of Surgery, New Haven, CT, USA 2Yale University School Of Medicine, Division Of Pediatric Surgery, New Haven, CT, USA 3Yale University School Of Medicine, Division Of Pediatric Urology, New Haven, CT, USA
Introduction:
Recreational and competitive sports are core components for physical fitness within pediatric patients throughout the United States. Each sport with its varied rules and regulations presents unique circumstances under which unique types of traumas might occur. Lacrosse, a sport played with a hard, dense ball, long sticks, used to hit opposing players, and padding only covering the upper body, anecdotally appears to lead to the most testicular injuries. In order to study this, we utilized the National Electronic Injury Surveillance System (NEISS) database to assess for which sports and recreational activities leads to the most frequent cause testicular and male genital injuries in male pediatric patients.
Methods:
The NEISS database was queried for male patients between the ages of 6 and 18, who were treated or held for observation between 1/1/2018 and 12/31/2022. Nine distinct sports or recreational activities were chosen to be studied, including Football, Basketball, Baseball/Softball, Soccer, Hockey, Volleyball, Lacrosse, Horseback Riding, and Bicycles/Motorized Bikes. Testicular and genital injuries were identified based upon the narrative diagnosis within the NEISS database, in addition to body part coding. Fisher’s exact, chi square, and logistic regression tests were utilized for statistical analysis. Significance was defined as p < 0.05.
Results:
313,036 patients were included in the analysis, of whom 1,783 (0.57%) patients had a testicular injury of some sort. There were 125,713 patients with an injury related to one of the studied activities, 1,390 of which were related to lacrosse. 2.0% of all lacrosse injuries resulted in testicular injury, the most of any sport even with controlling for age, race, and calendar year (Figure 1, RR 3.45 p < 0.0001). Further, despite lacrosse representing only 0.44% of all injuries studied in the given population, the sport was responsible for 1.57% of all testicular injuries reported (p < 0.0001).
Conclusion:
NEISS database results indicate that lacrosse is the most injurious sport to pediatric testicles and male genitals of any of the major recreational sports within the US. According to US Lacrosse, the sport’s national governing body, the number of lacrosse participants grew by 59% from 2008 to 2018. Although injuries due to lacrosse in this study were less commonly seen than other sports due to its relative popularity, as the sport continues to grow, so too will the number of injured participants, and by extension injured testicles and male genitals.
