Department of Urology, University of Washington, Seattle, USA.
Department of General Surgery, Sutter Health, Sacramento, USA.
Int Urol Nephrol. 2023 Jul;55(7):1665-1670. doi: 10.1007/s11255-023-03620-2. Epub 2023 May 17.
To describe our experience in the management and outcomes of female patients with urethral or bladder neck (BN) injury at a high-volume Level 1 trauma center.
A retrospective chart review of all female patients with urethral or BN injury by blunt trauma mechanism admitted to a Level 1 trauma center between 2005 and 2019 was performed.
Ten patients met study criteria with median age 36.5 years. All had concomitant pelvic fractures. All injuries were confirmed operatively, with no delayed diagnoses. Two patients were lost to follow up. One patient was not eligible for early repair of urethral injury and had two repairs of a urethrovaginal fistula. Two of seven (29%) patients who underwent early repair of their injury had an early Clavien grade > 2 complication, with none reporting long-term complications at median follow-up of 15.2 months.
Intraoperative evaluation is critical in the diagnosis of female urethral and BN injury. In our experience, acute surgical complications are not uncommon after the management of such injuries. However, there were no reported long-term complications in those patients who had prompt management of their injury. This aggressive diagnostic and surgical strategy is instrumental in attaining excellent surgical outcomes.
描述我们在一家高容量 1 级创伤中心对女性尿道或膀胱颈（BN）损伤患者进行管理和治疗的经验。
对 2005 年至 2019 年间在 1 级创伤中心因钝性创伤机制导致尿道或 BN 损伤的所有女性患者进行回顾性图表审查。
10 名患者符合研究标准，中位年龄为 36.5 岁。所有患者均有骨盆骨折。所有损伤均经手术证实，无延迟诊断。两名患者失访。一名患者不适合早期修复尿道损伤，且有两次尿道阴道瘘修复。7 名早期修复损伤的患者中有 2 名（29%）出现早期 Clavien 分级>2 级并发症，在中位随访 15.2 个月时，无患者报告长期并发症。
术中评估对女性尿道和 BN 损伤的诊断至关重要。根据我们的经验，在处理此类损伤后，急性手术并发症并不少见。然而，在那些及时处理损伤的患者中，没有报告长期并发症。这种积极的诊断和手术策略对获得良好的手术效果至关重要。
