Paparel P, Ruffion A
Service de chirurgie urologique et de la transplantation rénale, Centre hospitalier Lyon Sud, 165, chemin du Grand Revoyet, 69495 Pierre-Bénite, France.
Ann Urol (Paris). 2006 Aug;40(4):267-72. doi: 10.1016/j.anuro.2006.05.004.
Rupture of corpora cavernosa is a rare disease in young adults. In western countries, the most frequent cause is the so-called "faux pas du coït". In the Middle East, masturbation and penis manipulations aimed at stopping morning erection are the most frequent causes. The fracture which is audible by the patient is accompanied by a rapid detumescence with progressive onset of a haematoma. Diagnosis is based on clinical findings but radiological investigations such as MRI, ultrasonography or cavernography may help localizing the exact fracture site. The treatment of albugineal ruptures is surgery, in an elective manner whenever possible; it consists in the eviction of the subcutaneous haematoma, the suture of the albuginea and treatment of a potentially associated urethral rupture. Conservative treatment is exceptional and limited to patients who reject surgery, since it generates more complications: painful erections, persistent haematoma with a risk of infection, arteriovenous fistula, impotence, and unrecognized urethral rupture. Patients must be clearly informed on all these complications.
阴茎海绵体破裂是一种在年轻男性中较为罕见的疾病。在西方国家，最常见的病因是所谓的“性交失误”。在中东地区，自慰以及为阻止晨勃而对阴茎进行的操作是最常见的病因。患者能听到的断裂声会伴随着阴茎迅速消肿，并逐渐出现血肿。诊断基于临床症状，但诸如磁共振成像（MRI）、超声检查或海绵体造影等影像学检查可能有助于确定确切的破裂部位。白膜破裂的治疗方法是手术，只要有可能应选择择期手术；手术包括清除皮下血肿、缝合白膜以及处理可能伴发的尿道破裂。保守治疗极为少见，仅适用于拒绝手术的患者，因为保守治疗会引发更多并发症：疼痛性勃起、持续性血肿并有感染风险、动静脉瘘、阳痿以及未被识别的尿道破裂。必须向患者清楚告知所有这些并发症。
