Holland A J, Cohen R C, McKertich K M, Cass D T
Department of Surgical Research, The New Children's Hospital, Royal Alexandra Hospital for Children, Parramatta, NSW, Australia.
Pediatr Surg Int. 2001;17(1):58-61. doi: 10.1007/s003830000438.
We report our 12-year experience in the management of urethral injuries in nine children, six boys and three girls. The most common mechanisms of injury were motor vehicle accidents, followed by straddle injuries. All the injuries in boys involved the anterior urethra, and in girls the proximal or mid-urethra. There were associated injuries in five, including three pelvic fractures. All children were investigated with a retrograde urethrogram. Four were treated non-operatively with insertion of a urethral catheter. Of the remaining five, one had drainage of a penile haematoma, one cystourethroscopy, two insertion of urinary and suprapubic catheters, and one open cystotomy and passage of a guide wire with antegrade passage of a urethral catheter. Complications included one urinary tract infection, one urethral fistula, one urethrovaginal fistula, and two urethral strictures. Final outcome was satisfactory in all nine children.
我们报告了9名儿童(6名男孩和3名女孩)尿道损伤的12年管理经验。最常见的损伤机制是机动车事故,其次是骑跨伤。男孩的所有损伤均累及前尿道,女孩的损伤累及近端或中段尿道。5例伴有其他损伤,包括3例骨盆骨折。所有儿童均接受逆行尿道造影检查。4例通过插入尿道导管进行非手术治疗。其余5例中,1例行阴茎血肿引流,1例行膀胱尿道镜检查,2例行导尿管和耻骨上膀胱造瘘管插入术,1例行开放性膀胱切开术并通过导丝顺行插入尿道导管。并发症包括1例尿路感染、1例尿道瘘、1例尿道阴道瘘和2例尿道狭窄。9名儿童的最终结果均令人满意。