Pinggera G-M, Rehder P, Bartsch G, Gozzi C
Abteilung für Urologie, Medizinische Universitätsklinik Innsbruck, Osterreich.
Urologe A. 2005 Aug;44(8):883-97. doi: 10.1007/s00120-005-0865-x.
Urethral lesions may be caused by blunt or penetrating objects in the course of accidents, or can be iatrogenic resulting from invasive measures such as catheterization or other major surgical measures (prostatectomy or sling operations for continence). They can also be caused by foreign bodies deliberately introduced into the urethra. Injuries may primarily affect the anterior or posterior urethra. Urethral reconstruction presupposes knowledge of the precise anatomy of the pelvic region. The surgical techniques used and the timing of reconstructive procedures will depend on the cause and nature of the urethral injury. A definitive surgical intervention in most cases of lesions resulting from accidents is not generally recommended, especially when the lesion is in the posterior urethra. A treatment algorithm should prevent post-surgical complications such as incontinence, impotence, recurring urinary tract infections, etc., necessitating multiple operations, and assure an adequate quality of life. Diagnostic clarification of the exact nature of urethral injuries requires high quality imaging studies by specialists in the field.
尿道损伤可能由事故中钝器或锐器所致,也可能是医源性的,如导尿或其他大型外科手术(前列腺切除术或用于控制尿失禁的吊带手术)等侵入性操作引起。它们还可能由故意插入尿道的异物导致。损伤可能主要影响前尿道或后尿道。尿道重建需要了解盆腔区域的精确解剖结构。所采用的手术技术和重建手术的时机将取决于尿道损伤的原因和性质。对于大多数因事故导致的损伤病例,一般不建议进行确定性手术干预,尤其是当损伤位于后尿道时。治疗方案应预防术后并发症,如尿失禁、阳痿、反复尿路感染等,避免需要多次手术,并确保有足够的生活质量。明确尿道损伤的确切性质需要该领域的专家进行高质量的影像学检查。