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腹腔镜根治性膀胱前列腺切除术术后导管牵引导致阴茎龟头和海绵体广泛坏死:一例罕见病例报告及文献复习。

Extensive penile glans and corpus spongiosum necrosis due to catheter traction following laparoscopic radical cystoprostatectomy: a rare case report and literature review.

机构信息

Department of Urology, Health Sciences University HaydarpasaNumune Training and Research Hospital, İstanbul, Turkey.

出版信息

BMC Urol. 2023 Jul 10;23(1):115. doi: 10.1186/s12894-023-01289-4.

Abstract

BACKGROUND

Penile glans and corpus spongiosum necrosis is an extremely rare urologic condition associated with substantial morbidity.

CASE PRESENTATION

We report a rare case presenting extensive penile glans and corpus spongiosum necrosis following catheter traction in a 71-year-old male patient who had a laparoscopic radical cystoprostatectomy for muscle-invasive bladder cancer. The patient has no preexisting diabetes mellitus or chronic renal failure. The case was successfully managed with penile preservation. During the procedure, it was observed that the necrosis was not limited to the glans. The necrosis had spread to the entire penile urethra and corpus spongiosum, and an excision of approximately 14 cm of corpus spongiosum was performed.

CONCLUSION

This is the first case presenting extensive length of penile glans and corpus spongiosum necrosis managed successfully with penile preservation, enabling reaching the best functional and esthetic results reported in the literature. Early detection and urgent imaging with a high index of suspicion ensure a favorable outcome. The main treatment steps are careful evaluation, appropriate therapy, and prompt intervention depending on the severity.

摘要

背景

阴茎龟头和海绵体坏死是一种与严重发病率相关的极其罕见的泌尿科疾病。

病例介绍

我们报告了一例罕见病例,一名 71 岁男性患者因肌层浸润性膀胱癌行腹腔镜根治性膀胱前列腺切除术,在接受导管牵引后出现广泛的阴茎龟头和海绵体坏死。该患者无既往糖尿病或慢性肾衰竭病史。该病例通过阴茎保留成功治疗。在手术过程中,观察到坏死不仅限于龟头。坏死已蔓延至整个阴茎尿道和海绵体,进行了约 14 厘米的海绵体切除术。

结论

这是首例广泛长度的阴茎龟头和海绵体坏死成功通过阴茎保留治疗的病例,能够达到文献报道的最佳功能和美学效果。早期检测和高度怀疑的紧急影像学检查可确保良好的结果。主要的治疗步骤是根据严重程度进行仔细评估、适当治疗和及时干预。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4c1b/10334505/44e689d3da59/12894_2023_1289_Fig1_HTML.jpg

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