Martínez Portillo F J, Seif C, Braun P M, Spahn M, Alken P, Jünemann K-P
Klinik und Poliklinik für Urologie, Christian-Albrechts-Universität zu Kiel.
Aktuelle Urol. 2003 Jan;34(1):33-6. doi: 10.1055/s-2003-37557.
This paper reviews the current status of information on diagnostic and therapeutic management of penile fractures, focusing on the controversy between surgical vs. conservative treatment of this uncommon injury. Penile fracture, commonly defined as a rupture of the tunica albuginea and corpus cavernosum, is a serious urological disorder demanding surgical management. The diagnostic procedure classically consists of history taking, physical examination and urinary status. Determination of the extent of severity and location of the rupture in the tunica albuginea takes foremost priority and requires additional imaging procedures, such as ultrasound or cavernosography, which will impart enough diagnostic information for the correct choice of treatment. In some cases, the urethra is injured as well. Immediate surgical repair offers complete recovery for patients with penile fracture in most cases, even in the presence of urethral injury. Although penile fracture is easily recognized and can therefore be classified as a "first-look diagnosis", therapy remains controversial to date. The correct therapeutical approach is a vital factor in management, as the associated significant morbidity can result in complete loss of erectile function, painful erections or penis deviation. Early surgical treatment is strongly recommended because of the excellent results, shorter hospitalization, less morbidity and an early return to sexual activity.
本文回顾了阴茎骨折诊断与治疗管理的信息现状，重点关注这种罕见损伤的手术治疗与保守治疗之间的争议。阴茎骨折通常定义为白膜和海绵体破裂，是一种需要手术治疗的严重泌尿系统疾病。诊断程序通常包括病史采集、体格检查和尿液情况检查。确定白膜破裂的严重程度和位置最为重要，需要额外的影像学检查，如超声或海绵体造影，这些检查将为正确选择治疗方法提供足够的诊断信息。在某些情况下，尿道也会受伤。即使存在尿道损伤，立即进行手术修复在大多数情况下也能使阴茎骨折患者完全康复。尽管阴茎骨折很容易识别，因此可归类为“一目了然的诊断”，但迄今为止治疗仍存在争议。正确的治疗方法是管理中的关键因素，因为相关的严重发病率可能导致勃起功能完全丧失、疼痛性勃起或阴茎弯曲。由于效果良好、住院时间短、发病率低且能早日恢复性活动，强烈建议早期进行手术治疗。
