Tauber M, Joos H, Karpik S, Lederer S, Resch H
Universitätsklinik für Unfallchirurgie und Sporttraumatologie, Salzburg, Osterreich.
Unfallchirurg. 2007 Feb;110(2):116-23. doi: 10.1007/s00113-006-1206-2.
Follow-up of patients with pelvic ring fractures and associated injuries of the lower urogenital tract was performed from January 2000 to October 2004. Analysis focused on incidence, fracture type, type of urogenital injury, associated intrapelvic lesions, mortality, and urologic outcome.
The retrospective study included 18 of 111 patients (16.2%). Nine patients had a rupture of the urethra, six a rupture of the bladder, three a rupture of the penile root, and two a gonadal defect. The type of the pelvic ring fracture according to the AO classification was type A in 1, type B in 6, and type C in 11 cases. Fifteen patients (83.3%) were followed up clinically for a mean duration of 26 months (range: 12-66 months) after trauma. Seven patients were asymptomatic concerning the urogenital injury, five had erectile dysfunction, two had urethral stenosis, in one case associated with incontinence, and one patient with bilateral defect of the testicles was under hormone substitution therapy.
Urogenital injuries, often associated with intrapelvic lesions in so-called complex pelvic trauma, are typical for high-grade pelvic ring fractures and have an essential prognostic value for the patient's morbidity and quality of life.
2000年1月至2004年10月对骨盆环骨折及下泌尿生殖道相关损伤患者进行了随访。分析重点在于发病率、骨折类型、泌尿生殖道损伤类型、盆腔内相关病变、死亡率及泌尿外科治疗结果。
这项回顾性研究纳入了111例患者中的18例(16.2%)。9例患者发生尿道断裂,6例膀胱破裂,3例阴茎根部断裂,2例性腺缺损。根据AO分类,骨盆环骨折类型为A型1例,B型6例,C型11例。15例患者(83.3%)在创伤后接受了平均26个月(范围:12 - 66个月)的临床随访。7例患者泌尿生殖道损伤无症状,5例有勃起功能障碍,2例有尿道狭窄,其中1例伴有尿失禁,1例双侧睾丸缺损患者接受激素替代治疗。
在所谓的复杂骨盆创伤中,泌尿生殖道损伤常与盆腔内病变相关,是高级别骨盆环骨折的典型表现,对患者的发病率和生活质量具有重要的预后价值。