Rubio Briones J, Sánchez Martín F, Segura Paños A, Regalado Pareja R, Caffaratti Sfullini J, Ruiz-Castañé E, Villavicencio Mavrich H, Vicente Rodríguez Y J
Servicio de Urología, IUNA, Barcelona, España.
Arch Esp Urol. 1996 Jun;49(5):499-506.
Rupture of the corpora cavernosa, also known as fracture of the penis, is uncommon. To date, only 200 cases approximately have been reported. This lesion may be associated with rupture of the urethra in 25% of the cases. The diagnostic methods, management and the results achieved in these patients are discussed.
We describe two cases that had been treated at our institution and review the literature.
Preservation of micturition and sexual function was achieved with early surgical management in these two patients with a follow-up of more than one year.
An associated urethral lesion should be strongly suspected in the presence of urethrorrhagia. A negative urine sediment discards the presence of this lesion. If urethral injury associated with penile rupture is suspected, low pressure urethrography is the diagnostic method of choice following sonographic evaluation of the corpora cavernosa. Cavernosal integrity can only be established by cavernosography in equivocal cases and is not required when extravasation is demonstrated by urethrography. Conservative management carries a high risk of penile curvature and painful erection; therefore, whenever possible, surgery should be performed within a few hours following trauma and after careful evaluation. The cavernosal defect is repaired and end-to-end anastomosis of the urethra is performed. The patient should be informed of the risk of painful erection, penile curvature and urethral stenosis.
阴茎海绵体破裂，又称阴茎骨折，较为罕见。迄今为止，大约仅报道过200例。在25%的病例中，此病变可能伴有尿道破裂。本文讨论了这些患者的诊断方法、治疗及治疗结果。
我们描述了在我院治疗的两例病例并回顾了相关文献。
这两名患者经早期手术治疗，随访一年以上，排尿及性功能均得以保留。
出现尿道出血时，应高度怀疑存在相关尿道病变。尿沉渣阴性可排除该病变。如果怀疑阴茎破裂伴有尿道损伤，在对阴茎海绵体进行超声评估后，低压尿道造影是首选的诊断方法。在不明确的病例中，只有通过海绵体造影才能确定海绵体的完整性，而当尿道造影显示有外渗时则无需进行海绵体造影。保守治疗存在阴茎弯曲和疼痛性勃起的高风险；因此，只要有可能，应在创伤后数小时内并经过仔细评估后进行手术。修复海绵体缺损并进行尿道端端吻合。应告知患者存在疼痛性勃起、阴茎弯曲和尿道狭窄的风险。
