Kong Jennifer P L, Bultitude Matthew F, Royce Peter, Gruen Russell L, Cato Alex, Corcoran Niall M
Rev Urol. 2011;13(3):119-30.
Lower urinary tract trauma, although relatively uncommon in blunt trauma, can lead to significant morbidity when diagnosed late or left untreated; urologists may only encounter a handful of these injuries in their career. This article reviews the literature and reports on the management of these injuries, highlighting the issues facing clinicians in this subspecialty. Also presented is a structured review detailing the mechanisms, classification, diagnosis, management, and complications of blunt trauma to the bladder and urethra. The prognosis for bladder rupture is excellent when treated. Significant intraperitoneal rupture or involvement of the bladder neck mandates surgical repair, whereas smaller extraperitoneal lacerations may be managed with catheterization alone. With the push for management of trauma patients in larger centers, urologists in these hospitals are seeing increasing numbers of lower urinary tract injuries. Prospective analysis may be achieved in these centers to address the current lack of Level 1 evidence.
下尿路创伤在钝性创伤中相对少见，但如果诊断延迟或未得到治疗，可能导致严重的发病情况；泌尿外科医生在其职业生涯中可能仅遇到少数此类损伤。本文回顾了相关文献并报告了这些损伤的处理方法，突出了该亚专业临床医生面临的问题。还介绍了一项结构化综述，详细阐述了膀胱和尿道钝性创伤的机制、分类、诊断、处理及并发症。膀胱破裂经治疗后预后良好。严重的腹膜内破裂或膀胱颈受累需要手术修复，而较小的腹膜外撕裂伤单独通过导尿即可处理。随着大型中心对创伤患者进行管理的推进，这些医院的泌尿外科医生见到的下尿路损伤病例越来越多。在这些中心可以进行前瞻性分析，以解决目前缺乏一级证据的问题。
