Sports-related male genital trauma in the United States: insights from the National Electronic Injury Surveillance System (NEISS), 2014-2023.

Abstract

To characterise epidemiological patterns, trends, and disparities in sports-related male genital injuries presenting to emergency departments in the United States. Male genital injuries associated with sports and recreational activities from 2014 to 2023 were identified in the National Electronic Injury Surveillance System (NEISS) using activity codes and anatomical keyword searches. Weighted national estimates (NEs) and incidence rates (IRs) per 100 000 population were calculated with data from the United States Census Bureau. Analyses were stratified by age, race, and sport. Logistic regression was conducted to assess odds of hospital admission vs observation by injury location, sports category, and age. Linear regression evaluated temporal trends. Over the study period, 3034 cases represented an estimated 93 225 injuries nationwide (95% confidence interval [CI] 70 991-115 460). Over time, NE rose modestly but IR declined with population growth. Adolescents aged 15-19 years had the highest injury burden (NE = 25 073, 95% CI 19 683-30 463). Basketball (NE = 12 650; IR = 0.26) and football (NE = 11 292; IR = 0.25) were most frequently involved. Hospital admission odds for scrotal injuries were significantly higher than for penile injuries (odds ratio 30.7, 95% CI 1.4-670.0; P = 0.011). Injuries peaked among adolescents aged 10-19 years, particularly in basketball, soccer, football, and weightlifting. Older adults (aged ≥65 years) predominantly sustained golf-related injuries. Testicular injuries were most common (63.6%), and the majority of cases occurred among White individuals (46%), highlighting important demographic patterns. Sports-related male genital injuries predominantly affect adolescents and young adults, with basketball, football, and weightlifting posing the highest risks. Enhanced protective equipment, adherence to safety standards, targeted education, and sport-specific guidelines are critical to reducing injury burdens.