Kudriavtsev L A
Urol Nefrol (Mosk). 1992 Jan-Feb(1-3):38-43.
The membranous part of the urethra has anatomic specificity influencing its trauma mechanism and allowed for in the trauma treatment policy. In 239 patients with an injured membranous part of the urethra described in the paper, the rupture was mainly due to the hip fracture. 85% of the patients developed a complete rupture with subsequent obliteration, 15% had strictures. Cicatrization involved the whole membranous part in 74% of the cases. In relevant traumas common are severe rectourethral and peritoneal fistulas surgical treatment of which as well as obliterations involves great technical difficulties. There is a variety of operative approaches and techniques (perineal, original anteropubic and anorectal). Urethral reconstruction should not be followed by bougienage. Typical are also frequent renal and genital complications (phlegmons, nephroliths, ureteroliths, epididymitis, orchitis, prostatitis, pyelonephritis). The number of complications depends on the choice of the adequate operative technique and due consideration of anatomical characteristics of the membranous part of the urethra.
尿道膜部具有解剖学特异性，这会影响其创伤机制，并在创伤治疗策略中有所考量。在该论文所描述的239例尿道膜部损伤患者中，破裂主要是由髋部骨折导致。85%的患者发生完全破裂并随后闭锁，15%有狭窄。74%的病例中，瘢痕形成累及整个膜部。在相关创伤中，严重的直肠尿道瘘和腹膜瘘很常见，其手术治疗以及闭锁的处理存在很大技术困难。有多种手术入路和技术（会阴入路、原始耻骨前入路和肛门直肠入路）。尿道重建后不应进行尿道扩张。常见的还有频繁的肾脏和生殖系统并发症（蜂窝织炎、肾结石、输尿管结石、附睾炎、睾丸炎、前列腺炎、肾盂肾炎）。并发症的数量取决于合适手术技术的选择以及对尿道膜部解剖特征的充分考虑。
