Kim Jin K, Koyle Martin A, Lee Min Joon, Nason Gregory J, Ren Lily Yuxi, O'Kelly Fardod
Department of Surgery, University of Toronto, Toronto, Canada; Division of Urology, The Hospital for Sick Children, Toronto, Canada.
Department of Surgery, University of Toronto, Toronto, Canada; Division of Urology, The Hospital for Sick Children, Toronto, Canada.
J Pediatr Urol. 2020 Apr;16(2):130-148. doi: 10.1016/j.jpurol.2019.12.019. Epub 2020 Jan 7.
Genitourinary injuries in athletes engaging in high-impact sports such as football and rugby may have catastrophic consequences, especially in individuals with pre-existing urologic concerns, such as a solitary kidney.
To summarize the current literature on football-related or rugby-related genitourinary organ injuries in both adult and pediatric populations in an effort to risk stratify the likelihood of these injuries.
An independent systematic literature search for records reporting football-related or rugby-related injuries was conducted by a certified librarian and reviewer in March 2019. The search electronic databases included Medline, EMBASE, Scopus, and Web of Science. All studies reporting football-related or rugby-related genitourinary injuries were included.
Twenty-two records (11 research studies, 11 case reports) were identified. In the pediatric population, the reported football-related kidney injuries were 0.1-0.7% of all football-related injuries, 0.07-0.5% of all sports-related injuries, and 1.5-37.5% of all sports-related genitourinary injuries, with incidence ranging from 0.00000084 to 0.0000092 injuries per exposure (five studies). Pediatric football-related testicular injuries were reported to be 0.11% of all football injuries, 0-0.07% of all sports-related injuries, and 0-37.5% of all sports-related genitourinary injuries; injury per exposure was 0.0000092 (four studies). In adults, there was no proportion of genitourinary injuries that could be determined, and football-related kidney injury incidence was 0.000012 injuries per exposure (one study). No adult literature investigated testicular injuries. Eleven case reports were additionally identified. Review of the case reports suggests that patients with previously existing urologic abnormalities such as ureteropelvic junction obstruction may predispose an individual to kidney injuries.
There is little to suggest that those engaged in football or rugby have a significant risk of genitourinary injury; therefore, future guidelines should reflect this.
从事足球和橄榄球等高冲击力运动的运动员发生泌尿生殖系统损伤可能会产生灾难性后果，尤其是对于那些已有泌尿系统问题的个体，比如单肾患者。
总结当前关于成人和儿童人群中与足球或橄榄球相关的泌尿生殖器官损伤的文献，以便对这些损伤的发生风险进行分层。
2019年3月，一名经过认证的图书馆员和评审员独立进行了系统的文献检索，以查找报告与足球或橄榄球相关损伤的记录。检索的电子数据库包括Medline、EMBASE、Scopus和科学网。纳入所有报告与足球或橄榄球相关的泌尿生殖系统损伤的研究。
共识别出22条记录（11项研究、11例病例报告）。在儿童人群中，报告的与足球相关的肾损伤占所有与足球相关损伤的0.1%-0.7%，占所有与运动相关损伤的0.07%-0.5%，占所有与运动相关泌尿生殖系统损伤的1.5%-至37.5%，每次暴露的发病率为0.00000084至0.0000092例损伤（五项研究）。据报告，儿童与足球相关的睾丸损伤占所有足球损伤的0.11%，占所有与运动相关损伤的0%-0.07%，占所有与运动相关泌尿生殖系统损伤的0%-37.5%；每次暴露的损伤率为0.0000092例（四项研究）。在成人中，无法确定泌尿生殖系统损伤的比例，与足球相关的肾损伤发病率为每次暴露0.000012例损伤（一项研究）。没有成人文献调查睾丸损伤。另外还识别出11例病例报告。对病例报告的回顾表明，先前存在泌尿系统异常（如输尿管肾盂连接处梗阻）的患者可能使个体更容易发生肾损伤。
几乎没有迹象表明从事足球或橄榄球运动的人有显著的泌尿生殖系统损伤风险；因此，未来的指南应反映这一点。
