School of Medicine, Indiana University, Indianapolis, IN 46202, United States.
Department of Urology, Indiana University, Indianapolis, IN 46202, United States.
Sex Med Rev. 2023 Dec 23;12(1):100-105. doi: 10.1093/sxmrev/qead041.
In the management of penile fractures, immediate surgical repair has resulted in better outcomes when compared with a conservative approach; however, there is currently no consensus on the treatment of patients presenting beyond the immediate period (>24 hours) following injury.
To examine the latest literature on management strategies in penile fracture and propose an optimal algorithm for the treatment of patients with delayed presentation.
A comprehensive search was conducted following the PRISMA-P 2020 guidelines. A search was performed in several databases with the following strategy: ("Penile fracture" OR "fracture of penis" OR "rupture of corpora cavernosa" OR "rupture of tunica albuginea") AND (management OR treatment OR surgery OR "surgical reconstruction" OR "surgical repair"). This resulted in 108 relevant articles. Two independent reviewers screened these articles according to the inclusion criteria. Full-text review of 56 articles was performed, and ultimately 20 studies were selected. Measures included the use of diagnostic imaging, timing of surgical repair (immediate, <24 hours after injury; delayed, >24 hours), surgical approach, and long-term complications (ie, erectile dysfunction and penile curvature).
The review highlighted the benefits of immediate surgical repair in penile fractures, demonstrating improved patient outcomes. Furthermore, it found that surgical repair should be considered even in cases with delayed presentation (>24 hours after injury). To better evaluate the long-term impact of delayed surgical intervention on patient outcomes, we recommend standardized postoperative follow-up, with routine assessments of erectile function and penile curvature.
Contemporary literature suggests that immediate and delayed surgical repair of penile fractures leads to adequate postoperative outcomes, and patients presenting >24 hours after injury should still be considered for surgery.
在阴茎骨折的治疗中，与保守治疗相比，立即进行手术修复会带来更好的结果；然而，对于受伤后超过 24 小时（即即时期后）就诊的患者，目前尚无治疗共识。
研究阴茎骨折治疗策略的最新文献，并提出延迟就诊患者治疗的最佳方案。
按照 PRISMA-P 2020 指南进行全面检索。采用以下策略在多个数据库中进行搜索：（“阴茎骨折”或“阴茎骨折”或“海绵体破裂”或“白膜破裂”）和（管理或治疗或手术或“手术重建”或“手术修复”）。这导致了 108 篇相关文章。两名独立评审员根据纳入标准筛选这些文章。对 56 篇文章进行了全文审查，最终选择了 20 项研究。评估指标包括诊断性影像学的使用、手术修复的时机（即时，伤后 24 小时内；延迟，伤后 24 小时以上）、手术方法和长期并发症（即勃起功能障碍和阴茎弯曲）。
综述强调了在阴茎骨折中立即进行手术修复的益处，证明了这种方法可改善患者结局。此外，研究发现，即使是延迟就诊（伤后 24 小时以上）的患者，也应考虑进行手术修复。为了更好地评估延迟手术干预对患者结局的长期影响，我们建议进行标准化的术后随访，常规评估勃起功能和阴茎弯曲。
当代文献表明，立即和延迟手术修复阴茎骨折均可获得良好的术后结局，对于伤后超过 24 小时就诊的患者，仍应考虑手术治疗。
