Muentener Michael, Suter Stefan, Hauri Dieter, Sulser Tullio
Department of Urology, University Hospital, Zurich, Switzerland.
J Urol. 2004 Aug;172(2):576-9. doi: 10.1097/01.ju.0000131594.99785.1c.
Immediate surgical repair is widely accepted as the therapy of choice in penile fracture. As recent reports show, good results can also be achieved in some patients with conservative management. It is unclear which patients will truly benefit from an operation. We retrospectively compared the long-term outcomes of surgical and conservative treatment in patients with penile fracture.
In 22 years we treated 29 patients with penile fracture. A total of 12 patients were treated with immediate surgical repair and 17 patients were treated conservatively. Patient charts were reviewed and all patients had followup by interview with an additional clinical evaluation if the result was not completely satisfactory. Outcome was rated good, moderate or poor.
Mean followup was 67 months. There was no statistical difference between patients in the surgery group and patients in the conservative group in regard to length of followup, age at presentation or length of hospital stay. In the surgery group and the conservative group 11 (92%) and 10 (59%) patients showed good outcome, respectively. Poor outcome was seen in 3 patients from the conservative group.
Overall, immediate surgery yields excellent results and is superior to nonoperative treatment in the management of penile fracture. However, conservative therapy restricted to uncomplicated cases can lead to an equally good outcome.
阴茎骨折的即刻手术修复被广泛认为是首选治疗方法。近期报告显示,一些采用保守治疗的患者也能取得良好效果。目前尚不清楚哪些患者能真正从手术中获益。我们回顾性比较了阴茎骨折患者手术治疗和保守治疗的长期疗效。
在22年里,我们共治疗了29例阴茎骨折患者。其中12例患者接受了即刻手术修复,17例患者接受了保守治疗。我们查阅了患者病历,并对所有患者进行了随访,若结果不完全令人满意,则通过访谈及额外的临床评估进行随访。结局分为良好、中等或差。
平均随访时间为67个月。手术组患者与保守组患者在随访时间、就诊年龄或住院时间方面无统计学差异。手术组和保守组分别有11例(92%)和10例(59%)患者结局良好。保守组有3例患者结局较差。
总体而言,即刻手术疗效极佳,在阴茎骨折治疗中优于非手术治疗。然而,仅限于无并发症病例的保守治疗也可取得同样良好的效果。