Spontaneous Rupture of the Testicle Secondary to Coughing in a Patient With New-Onset Heart Failure: A Case Report.

Spontaneous testicular rupture is an incredibly rare occurrence. There are no prior reported cases secondary to coughing or heart failure in the review of the current medical literature. There are other reports of testicular rupture, but these are secondary to trauma, malignancy, or infection, which are also rarely reported and otherwise not spontaneous. This is a report of a 68-year-old male who presented to the emergency department for complaints of pain and swelling in the scrotum and right groin that occurred after an episode of repeated coughing. The patient was found to have a spontaneous testicular rupture, causing an expanding hematoma that required operative management. The testicle, however, was not amenable to repair and required an orchiectomy to resolve the hemorrhage. The patient also presented with multiple additional medical problems requiring evaluation and medical optimization while hospitalized. Those additional problems were new-onset heart failure with reduced ejection fraction, cor pulmonale, and non-ST-segment elevation myocardial infarction (NSTEMI). The patient was ultimately able to be discharged home without complication from the spontaneous testicular rupture.