Goldman S M, Sandler C M, Corriere J N, McGuire E J
Department of Radiology, University of Texas Medical School Houston, USA.
J Urol. 1997 Jan;157(1):85-9. doi: 10.1016/s0022-5347(01)65291-1.
We propose a simple, anatomically based classification of blunt urethral injury as a replacement for currently used classifications, which are not comprehensive, anatomically inconsistent or based on a mixed anatomical/mechanistic formula. The latter are difficult to learn and use, and have not been universally adopted.
We reviewed most of the currently used general uroradiological, emergency radiological and urological textbooks to define the classification of urethral injuries that is most widely accepted. Most authors use the Colapinto and McCallum classification, modifications thereof or the older surgical classification of urethral injuries, which simply divides such injuries anatomically into anterior and posterior. However, there is little consensus about the best classification and none includes all of the blunt injuries of the urethra. To correct these difficulties we devised a comprehensive and anatomically consistent classification.
The proposed classification categorizes blunt urethral trauma as I-posterior urethra intact but stretched (Colapinto and McCallum type I), II-partial or complete pure posterior injury with tear of membranous urethra above the urogenital diaphragm (Colapinto and McCallum type II), III-partial or complete combined anterior/posterior urethral injury with disruption of the urogenital diaphragm (Colapinto and McCallum type III), IV-bladder neck injury with extension into the urethra, IVA-injury of the base of the bladder with periurethral extravasation simulating a true type IV urethral injury and V-partial or complete pure anterior urethral injury.
The proposed classification is anatomically valid and includes all of the common types of blunt urethral injuries. Universal adoption of this system should permit comparison of various management/treatment modalities at various institutions.
我们提出一种基于解剖学的简单钝性尿道损伤分类方法，以取代目前使用的分类方法，现有的分类方法不全面、解剖学上不一致或基于解剖学/机制混合公式。后者难以学习和使用，且未被普遍采用。
我们查阅了大多数目前使用的普通泌尿放射学、急诊放射学和泌尿外科学教科书，以确定最广泛接受的尿道损伤分类。大多数作者使用科拉平托和麦卡勒姆分类法、其修改版本或较旧的尿道损伤外科分类法，后者只是简单地将此类损伤在解剖学上分为前尿道和后尿道。然而，关于最佳分类几乎没有共识，而且没有一种分类包括所有钝性尿道损伤。为纠正这些问题，我们设计了一种全面且解剖学上一致的分类方法。
提议的分类将钝性尿道创伤分为：I型——后尿道完整但拉长（科拉平托和麦卡勒姆I型）；II型——部分或完全单纯性后尿道损伤，尿生殖膈上方的膜部尿道撕裂（科拉平托和麦卡勒姆II型）；III型——部分或完全性前后尿道联合损伤，尿生殖膈破裂（科拉平托和麦卡勒姆III型）；IV型——膀胱颈损伤并延伸至尿道，IVA——膀胱底部损伤伴尿道周围外渗，模拟真正的IV型尿道损伤；V型——部分或完全单纯性前尿道损伤。
提议的分类在解剖学上是有效的，包括所有常见的钝性尿道损伤类型。普遍采用该系统应能在各机构间比较各种管理/治疗方式。
