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阴茎骨折中的完全性尿道损伤:一例病例报告及文献综述

Complete urethral injury in the penile fracture: a case report and literature review.

作者信息

Ge Guangju, Wang Huan, Chen Yuanlei, Li Gonghui, Ma Liang

机构信息

Department of Urology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China.

出版信息

Transl Androl Urol. 2021 Feb;10(2):969-975. doi: 10.21037/tau-20-1155.

Abstract

Penile fracture is described as a traumatic rupture of the tunica albuginea caused by blunt injury to the erect penis. It usually occurs as a single rupture of the tunica albuginea in one of two corpora cavernosa; a rupture with urethral injury is an extremely rare condition. Although its diagnosis is usually clinical, ultrasound plays an important role in confirming diagnosis and identifying the site of the injury. Here, we presented a case of penile fracture with complete urethral injury. A 43-year-old male was admitted to the hospital because of trauma to the genital and dysuria following sexual intercourse. After admission, the patient was diagnosed with double penile fracture and complete urethral injury after the physical and B-ultrasound examinations. Emergency surgery to remove the hematoma and repair the urethra was performed. The patient recovered smoothly and was discharged on the third day after operation. After two months' follow-up, the patient urinated smoothly and achieved an adequate erection without other complications. In this case, consistent with previous studies, emergency surgery for penile fracture is necessary and can preserve the urethral function and sexual function. In addition, there are two lesions in tunica albuginea in this case, so careful search for the penile shaft during the surgery is important to avoid the missed injuries. This report provides evidence of an uncommon and underreported clinical case.

摘要

阴茎骨折被描述为由勃起阴茎受到钝性损伤导致的白膜创伤性破裂。它通常表现为两个海绵体之一的白膜单次破裂;伴有尿道损伤的破裂极为罕见。虽然其诊断通常依靠临床症状,但超声在确诊和确定损伤部位方面发挥着重要作用。在此,我们报告一例伴有完全性尿道损伤的阴茎骨折病例。一名43岁男性因性交后生殖器外伤和排尿困难入院。入院后,经体格检查和B超检查,患者被诊断为双侧阴茎骨折和完全性尿道损伤。遂行急诊手术清除血肿并修复尿道。患者恢复顺利,术后第三天出院。经过两个月的随访,患者排尿顺畅,勃起功能正常,未出现其他并发症。在本病例中,与既往研究一致,阴茎骨折的急诊手术是必要的,且可保留尿道功能和性功能。此外,本病例白膜有两处损伤,因此手术中仔细探查阴茎体对于避免漏诊损伤很重要。本报告提供了一个罕见且报道不足的临床病例证据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/033b/7947453/d0a108907041/tau-10-02-969-f1.jpg

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