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一级创伤中心的男性生殖器创伤。

Male genital trauma at a level 1 trauma center.

机构信息

Department of Urology, Harborview Medical Center, University of Washington, 325 9th Ave, Box 359868, Seattle, WA, 98104, USA.

Spokane Urology, Spokane, WA, USA.

出版信息

World J Urol. 2020 Dec;38(12):3283-3289. doi: 10.1007/s00345-020-03115-0. Epub 2020 Feb 20.

Abstract

OBJECTIVES

To describe our experience with men admitted to a tertiary care hospital with genital injury.

METHODS

Adult men with injuries of the genitals, admitted to our institution between January 2013 and June 2018, were identified from our institutional trauma registry. Patient charts were queried to extract mechanism, management, follow-up, and complications.

RESULTS

118 men met inclusion criteria. 39% and 61% sustained penetrating and blunt injuries, respectively. The most common mechanisms of penetrating trauma were external violence (48%) and self-inflicted injury (40%). The most common mechanisms of blunt trauma were motorcycle crash (33%) and sexual injury/intercourse (22%). 38% presented with penile and 71% with scrotal injuries. 48% of men with scrotal injuries had concomitant testis injury. 9.3% presented with both a penile and a scrotal injury. Concomitant urethral injuries were found in 17% of all genital injuries. Genital trauma was more common in the summer months. 74% of all genital injuries were managed operatively, with surgery more common after penetrating injury (89% vs 64%, p value < 0.01). 73% of 84 men with scrotal trauma were managed operatively. 27 men received surgical intervention for testis rupture, with a testicular salvage rate of 44%. 60 (51%) patients presented for follow-up. The median length of follow-up from initial injury was 29 (± 250) days. Of these, 9 (15%) patients developed one or more complications CONCLUSIONS: Genital injuries can occur via numerous mechanisms and frequently require operative intervention. Concomitant urethral injury is common. More work is needed to evaluate the long-term sequelae of these injuries.

摘要

目的

描述我们在一家三级保健医院治疗生殖器损伤的男性患者的经验。

方法

从我们的机构创伤登记处确定了 2013 年 1 月至 2018 年 6 月期间因生殖器损伤入院的成年男性患者。查询患者病历以提取损伤机制、处理方法、随访情况和并发症。

结果

符合纳入标准的患者有 118 人。40%和 61%分别发生穿透性和钝性损伤。穿透性损伤最常见的机制是外部暴力(48%)和自我伤害(40%)。钝性损伤最常见的机制是摩托车事故(33%)和性损伤/性交(22%)。38%的患者出现阴茎损伤,71%的患者出现阴囊损伤。48%的阴囊损伤患者伴有睾丸损伤。9.3%的患者同时出现阴茎和阴囊损伤。所有生殖器损伤中,17%伴有尿道损伤。生殖器损伤在夏季更为常见。74%的所有生殖器损伤均需手术治疗,穿透性损伤后手术更为常见(89%比 64%,p 值<0.01)。84 例阴囊损伤患者中有 73%接受了手术治疗。27 例因睾丸破裂接受手术干预,睾丸保留率为 44%。60(51%)例患者接受随访。从初次损伤到随访的中位时间为 29(±250)天。其中 9(15%)例患者出现 1 种或多种并发症。

结论

生殖器损伤可由多种机制引起,常需手术干预。同时伴有尿道损伤较为常见。需要进一步研究这些损伤的长期后果。

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