Koch M O
Department of Urology, Vanderbilt University Medical Center, Nashville, TN 37232-2765, USA.
Semin Urol. 1995 Feb;13(1):38-44.
Management of prostatomembranous urethral disruptions remains controversial. Advocates of delayed urethral reconstruction suggest that immediate repair provides inferior outcomes in terms of impotence and incontinence. However, review of the literature, provides strong evidence that the injury itself is the most important factor in determining outcome because impotence appears to be the result of injury to the corpora cavernosa. Moreover, techniques for immediate urethral realignment provide outcomes that are equivalent to delayed-repair approaches while eliminating the need for long-term suprapubic catheter drainage and multiple surgical procedures for reconstruction. Techniques for immediate urethral realignment, along with outcomes at the Vanderbilt University Medical Center (Nashville, TN) are presented. Potency and continence rates of 83% and 100% were achieved, with early realignment of complete prostatomembranous urethral disruptions. These results are comparable to or exceed those of delayed-repair approaches.
前列腺膜部尿道断裂的处理仍存在争议。主张延迟尿道重建的人认为，就阳痿和尿失禁而言，立即修复的效果较差。然而，文献回顾提供了有力证据，表明损伤本身是决定预后的最重要因素，因为阳痿似乎是海绵体损伤的结果。此外，即时尿道复位技术的效果与延迟修复方法相当，同时消除了长期耻骨上导管引流和多次重建手术的必要性。本文介绍了即时尿道复位技术以及范德比尔特大学医学中心（田纳西州纳什维尔）的治疗结果。对于完全性前列腺膜部尿道断裂进行早期复位后，性功能和控尿率分别达到了83%和100%。这些结果与延迟修复方法相当或更优。
