Cass A S
J Trauma. 1984 Oct;24(10):901-6. doi: 10.1097/00005373-198410000-00006.
A total of 74 patients with urethral injury due to external trauma consisted of 48 posterior urethral injuries (25 complete rupture, 23 partial rupture) and 26 anterior urethral injuries (two complete rupture, 16 partial rupture, and eight contusion). The diagnosis was made by retrograde urethrography. All 48 patients with posterior urethral injury had associated injuries, including a fractured pelvis in 46, and a mortality rate of 33%. Only seven of the 26 patients with anterior urethral injury had associated injuries and a mortality rate of 14%. The management of posterior urethral injury is changing from primary realignment of the ruptured urethra to suprapubic cystostomy alone and followed later by urethral surgery for the resulting stricture. The impotence rate is significantly lower with management with suprapubic cystostomy alone. However, the type of pelvic fracture, the urethral injury itself disrupting neurovascular structures, and the surgical dissection (initial primary realignment or delayed urethroplasty) must be investigated before it can be determined whether the impotence associated with pelvic trauma is caused by the injury itself or by the surgical dissection undertaken to reconstruct the urethra.
共有74例因外部创伤导致尿道损伤的患者，其中包括48例后尿道损伤（25例完全断裂，23例部分断裂）和26例前尿道损伤（2例完全断裂，16例部分断裂，8例挫伤）。诊断通过逆行尿道造影进行。所有48例后尿道损伤患者均伴有其他损伤，其中46例伴有骨盆骨折，死亡率为33%。26例前尿道损伤患者中只有7例伴有其他损伤，死亡率为14%。后尿道损伤的治疗方法正在从破裂尿道的一期复位转变为单纯耻骨上膀胱造瘘术，随后再进行尿道手术治疗由此产生的狭窄。单纯耻骨上膀胱造瘘术治疗后的阳痿发生率显著降低。然而，在确定与骨盆创伤相关的阳痿是由损伤本身还是由为重建尿道而进行的手术解剖引起之前，必须对骨盆骨折的类型、破坏神经血管结构的尿道损伤本身以及手术解剖（初始一期复位或延迟尿道成形术）进行研究。
