Jankowski Jason T, Spirnak J Patrick
Department of Urology, Case Western Reserve University, MetroHealth Medical Center, 2500 MetroHealth Drive, Room H947, Cleveland, OH 44109, USA.
Urol Clin North Am. 2006 Aug;33(3):365-76. doi: 10.1016/j.ucl.2006.04.004.
Three percent to 10% of trauma patients have genitourinary tract injuries. Radiologic imaging is essential for making the correct diagnosis and managing it appropriately. Which modality is appropriate is based on the mechanism of injury and patient presentation. Patients with pelvic injuries and gross hematuria should undergo either CT cystography or conventional cystography. Ultrasound is warranted in patients with scrotal trauma when physical exam is inconclusive. Patients with penetrating trauma to the external genitalia, who suffer blunt trauma to the penis, or who present with gross hematuria, blood at the meatus, inability to void, perineal/scrotal ecchymosis, or abnormal digital rectal exam should undergo retrograde urethrography. Using these criteria for imaging should lead to the proper diagnosis and minimize patient morbidity.
3%至10%的创伤患者存在泌尿生殖道损伤。放射学成像对于做出正确诊断并进行适当处理至关重要。选择何种检查方式应基于损伤机制和患者表现。伴有骨盆损伤和肉眼血尿的患者应接受CT膀胱造影或传统膀胱造影。当体格检查结果不明确时，阴囊外伤患者有必要进行超声检查。有外生殖器穿透伤、阴茎钝挫伤、或出现肉眼血尿、尿道口溢血、无法排尿、会阴/阴囊瘀斑或直肠指检异常的患者应接受逆行尿道造影。采用这些成像标准应能实现正确诊断并将患者发病率降至最低。
