Manjunath Adarsh S, Hofer Matthias D
Department of Urology, Northwestern University Feinberg School of Medicine, 303 East Chicago Avenue 16-703, Chicago, IL 60611, USA.
Department of Urology, Northwestern University Feinberg School of Medicine, 303 East Chicago Avenue 16-703, Chicago, IL 60611, USA.
Med Clin North Am. 2018 Mar;102(2):373-385. doi: 10.1016/j.mcna.2017.10.013. Epub 2017 Dec 20.
Urologic emergencies can involve the kidneys, ureters, bladder, urethra, penis, scrotum, or testicles. History and physical examination are essential to diagnosis, whereas imaging is increasingly used to confirm diagnoses. Acute urinary retention should be relieved with Foley placement. Penile emergencies include paraphimosis, which can be treated by foreskin reduction, whereas penile fracture and priapism require urologic intervention. Fournier gangrene and testicular torsion are scrotal emergencies requiring emergent surgery. Nephrolithiasis, although painful, is not an emergency unless there is concern for concomitant urinary tract infection, both ureters are obstructed by stones, or there is an obstructing stone in a solitary kidney.
泌尿外科急症可累及肾脏、输尿管、膀胱、尿道、阴茎、阴囊或睾丸。病史和体格检查对诊断至关重要,而影像学检查越来越多地用于确诊。急性尿潴留应通过放置 Foley 导尿管来缓解。阴茎急症包括包皮嵌顿,可通过包皮复位治疗,而阴茎骨折和阴茎异常勃起则需要泌尿外科干预。坏死性筋膜炎和睾丸扭转是需要紧急手术的阴囊急症。肾结石虽然疼痛,但除非担心合并尿路感染、双侧输尿管均被结石阻塞或孤立肾中有阻塞性结石,否则不属于急症。