Orvis B R, McAninch J W
Department of Urology, University of California School of Medicine, San Francisco.
Urol Clin North Am. 1989 May;16(2):369-75.
Rupture of the corpus cavernosum is a rare injury; the characteristic history and physical findings usually yield the diagnosis. Blood at the meatus, any degree of hematuria, and difficulty with urination are suggestive of associated urethral injury, which occurs in 10 to 20 per cent of patients and indicates the need for retrograde urethrography. A review of the literature suggests that early surgical repair of the tunical defect is associated with a significantly lower risk of persistent penile angulation, a shorter hospital stay, and more rapid functional return. Conservative treatment may be warranted in cases with minimal hematoma if cavernosography reveals no extracorporal extravasation. Complete urethral disruption is best managed by primary repair, whereas partial disruption can be managed adequately by temporary suprapubic cystostomy. By following these guidelines, long-term morbidity can be kept to a minimum.
海绵体破裂是一种罕见的损伤；典型的病史和体格检查结果通常可得出诊断。尿道口有血、任何程度的血尿以及排尿困难提示存在相关的尿道损伤，10%至20%的患者会发生这种情况，这表明需要进行逆行尿道造影。文献回顾表明，早期手术修复白膜缺损与阴茎持续成角风险显著降低、住院时间缩短以及功能恢复更快相关。如果海绵体造影显示没有体外渗血，对于血肿最小的病例可考虑保守治疗。完全性尿道断裂最好通过一期修复处理，而部分断裂可通过临时性耻骨上膀胱造瘘充分处理。遵循这些指导原则，可将长期发病率降至最低。
